Provider Demographics
NPI:1972897395
Name:SHELDON C COHEN DMD PC DBA PREMIER DENTAL PARTNERS
Entity type:Organization
Organization Name:SHELDON C COHEN DMD PC DBA PREMIER DENTAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREATTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-361-0760
Mailing Address - Street 1:6 MCBRIDE AND SON CENTER DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 MCBRIDE AND SON CENTER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1418
Practice Address - Country:US
Practice Address - Phone:636-728-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty