Provider Demographics
NPI:1336151133
Name:COHEN, STUART RONALD (DMD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:RONALD
Last Name:COHEN
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 1:185 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5596
Mailing Address - Country:US
Mailing Address - Phone:207-783-1652
Mailing Address - Fax:207-784-2100
Practice Address - Street 1:185 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5596
Practice Address - Country:US
Practice Address - Phone:207-783-1652
Practice Address - Fax:207-784-2100
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist