Provider Demographics
NPI:1861616195
Name:SOL COHEN-SEDGH DENTAL CORPORATION
Entity type:Organization
Organization Name:SOL COHEN-SEDGH DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOLEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-858-9940
Mailing Address - Street 1:1406 N AZUSA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-1257
Mailing Address - Country:US
Mailing Address - Phone:626-858-9940
Mailing Address - Fax:626-858-9366
Practice Address - Street 1:1406 N AZUSA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-1257
Practice Address - Country:US
Practice Address - Phone:626-858-9940
Practice Address - Fax:626-858-9366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA389791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty