Provider Demographics
NPI:1093005167
Name:COHEN, MILA (DDS)
Entity type:Individual
Prefix:DR
First Name:MILA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 BRUNSWICK ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1589
Mailing Address - Country:US
Mailing Address - Phone:917-756-2889
Mailing Address - Fax:
Practice Address - Street 1:255 BRUNSWICK ST
Practice Address - Street 2:SUITE 5
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-1589
Practice Address - Country:US
Practice Address - Phone:917-756-2889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0563181223P0221X
NJ22DI025910001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry