Provider Demographics
NPI:1124096821
Name:COHEN, GREG (DDS)
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 SW 29TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-4274
Mailing Address - Country:US
Mailing Address - Phone:785-273-2350
Mailing Address - Fax:785-273-4252
Practice Address - Street 1:6231 SW 29TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4274
Practice Address - Country:US
Practice Address - Phone:785-273-2350
Practice Address - Fax:785-273-4252
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS67121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice