Provider Demographics
NPI:1457543548
Name:COHEN, ABRAHAM (DDS,INC)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:DDS,INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 10TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2857
Mailing Address - Country:US
Mailing Address - Phone:310-656-4000
Mailing Address - Fax:310-319-2025
Practice Address - Street 1:1450 10TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2857
Practice Address - Country:US
Practice Address - Phone:310-656-4000
Practice Address - Fax:310-319-2025
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA511701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice