Provider Demographics
NPI:1538107347
Name:COHEN, STANLEY (DDS)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
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 1:18109 PRINCE PHILIP DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1519
Mailing Address - Country:US
Mailing Address - Phone:301-774-1020
Mailing Address - Fax:301-774-1062
Practice Address - Street 1:18109 PRINCE PHILIP DR
Practice Address - Street 2:SUITE 250
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1519
Practice Address - Country:US
Practice Address - Phone:301-774-1020
Practice Address - Fax:301-774-1062
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD094151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice