Provider Demographics
NPI:1538215694
Name:COHEN, JEFFREY M (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:COHEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5718
Mailing Address - Country:US
Mailing Address - Phone:561-967-8200
Mailing Address - Fax:561-967-2215
Practice Address - Street 1:4324 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5718
Practice Address - Country:US
Practice Address - Phone:561-967-8200
Practice Address - Fax:561-967-2215
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00110451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice