Provider Demographics
NPI:1790854784
Name:COHEN, PAUL BARTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:BARTON
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 1:1910 ROUTE 70 E
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2123
Mailing Address - Country:US
Mailing Address - Phone:856-751-1808
Mailing Address - Fax:856-751-7162
Practice Address - Street 1:1910 MARLTON PIKE E
Practice Address - Street 2:SUITE 4
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2123
Practice Address - Country:US
Practice Address - Phone:856-751-1808
Practice Address - Fax:856-751-7162
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI009129001223S0112X
PADS017404L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ16606OtherAETNA
NJ156944OtherMEDICARE INDIV #
NJ156944OtherUNITED CONCORDIA
NJ159652OtherMEDICARE GROUP #
NJ16606OtherAETNA