Provider Demographics
NPI:1932272754
Name:COHEN, LEE ROBERT (DDS, MS, MS)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ROBERT
Last Name:COHEN
Suffix:
Gender:M
Credentials:DDS, MS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 VICTORIAN LN
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3781
Mailing Address - Country:US
Mailing Address - Phone:561-676-1200
Mailing Address - Fax:
Practice Address - Street 1:4520 DONALD ROSS ROAD, SUITE 110
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-691-0020
Practice Address - Fax:561-691-9707
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN151221223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics