Provider Demographics
NPI:1285972471
Name:DENTAL SLEEP APPLIANCE SERVICES LLC, MARVIN D. COHEN DDS
Entity type:Organization
Organization Name:DENTAL SLEEP APPLIANCE SERVICES LLC, MARVIN D. COHEN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-697-6080
Mailing Address - Street 1:75 ARCH ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1429
Mailing Address - Country:US
Mailing Address - Phone:330-697-6080
Mailing Address - Fax:330-375-6274
Practice Address - Street 1:75 ARCH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1429
Practice Address - Country:US
Practice Address - Phone:330-697-6080
Practice Address - Fax:330-375-6274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13454332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0215396Medicaid