Provider Demographics
NPI:1508964263
Name:COHEN, BRIAN P (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:P
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 1:9250 GLADES RD STE 208
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3958
Mailing Address - Country:US
Mailing Address - Phone:561-488-8898
Mailing Address - Fax:
Practice Address - Street 1:9250 GLADES RD STE 208
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3958
Practice Address - Country:US
Practice Address - Phone:561-488-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00078341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics