Provider Demographics
NPI:1891853255
Name:COHN, BRUCE RICHARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:RICHARD
Last Name:COHN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 BROKEN SOUND PKWY NW
Mailing Address - Street 2:SUITE 185
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3507
Mailing Address - Country:US
Mailing Address - Phone:561-999-9650
Mailing Address - Fax:
Practice Address - Street 1:850 IVES DAIRY RD
Practice Address - Street 2:SUITE T63
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-2450
Practice Address - Country:US
Practice Address - Phone:305-654-9399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN5655122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist