Provider Demographics
NPI:1104131051
Name:COHEN, CORAL N (DMD)
Entity type:Individual
Prefix:DR
First Name:CORAL
Middle Name:N
Last Name:COHEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16100 JUPITER FARMS RD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-6304
Mailing Address - Country:US
Mailing Address - Phone:561-614-4246
Mailing Address - Fax:
Practice Address - Street 1:16100 JUPITER FARMS RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478-6304
Practice Address - Country:US
Practice Address - Phone:561-614-4246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 19171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist