Provider Demographics
NPI:1144387804
Name:COHEN, JONATHAN H (DDS)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:H
Last Name:COHEN
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 1:9375 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4101
Mailing Address - Country:US
Mailing Address - Phone:954-341-0500
Mailing Address - Fax:954-345-9970
Practice Address - Street 1:9375 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4101
Practice Address - Country:US
Practice Address - Phone:954-341-0500
Practice Address - Fax:954-345-9970
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14426122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist