Provider Demographics
NPI:1710078589
Name:COHEN, ROBERT J (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
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 1:2925 AVENTURA BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3124
Mailing Address - Country:US
Mailing Address - Phone:305-932-1214
Mailing Address - Fax:305-682-7972
Practice Address - Street 1:2925 AVENTURA BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3124
Practice Address - Country:US
Practice Address - Phone:305-932-1214
Practice Address - Fax:305-682-7972
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 59941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL591503887OtherTAX IDENTIFICATION NUMBER