Provider Demographics
NPI:1558584490
Name:COHEN, GERALD S (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:S
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 1:11 COPPERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-2530
Mailing Address - Country:US
Mailing Address - Phone:508-998-1178
Mailing Address - Fax:508-995-1775
Practice Address - Street 1:1249 ASHLEY BLVD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1536
Practice Address - Country:US
Practice Address - Phone:508-998-1178
Practice Address - Fax:508-995-1775
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA117741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice