Provider Demographics
NPI:1033237896
Name:COHEN, EDWARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
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 1:52 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-2430
Mailing Address - Country:US
Mailing Address - Phone:781-784-9307
Mailing Address - Fax:
Practice Address - Street 1:64 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:NEWTON HIGHLANDS
Practice Address - State:MA
Practice Address - Zip Code:02461-1439
Practice Address - Country:US
Practice Address - Phone:617-965-3225
Practice Address - Fax:617-965-7501
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113341223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics