Provider Demographics
NPI:1497971287
Name:COHEN, JAY A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:A
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 1:13660 JOG RD
Mailing Address - Street 2:SUITE #6
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3806
Mailing Address - Country:US
Mailing Address - Phone:561-496-0320
Mailing Address - Fax:561-496-0022
Practice Address - Street 1:13660 JOG RD
Practice Address - Street 2:SUITE #6
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3806
Practice Address - Country:US
Practice Address - Phone:561-496-0320
Practice Address - Fax:561-496-0022
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist