Provider Demographics
NPI:1730568841
Name:COHEN, ADAM LOUIS (DMD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:LOUIS
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 1:2301 E EVESHAM RD STE 211
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4504
Mailing Address - Country:US
Mailing Address - Phone:856-437-4432
Mailing Address - Fax:
Practice Address - Street 1:2301 E EVESHAM RD STE 211
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4504
Practice Address - Country:US
Practice Address - Phone:856-437-4432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040373122300000X
NJ22DI027905001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist