Provider Demographics
NPI:1053502344
Name:COHRS, RICHARD MARTIN (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:MARTIN
Last Name:COHRS
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 1:554 WEST BADILLO STREET
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3762
Mailing Address - Country:US
Mailing Address - Phone:626-339-4003
Mailing Address - Fax:626-339-7751
Practice Address - Street 1:554 WEST BADILLO STREET
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3762
Practice Address - Country:US
Practice Address - Phone:626-339-4003
Practice Address - Fax:626-339-7751
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice