Provider Demographics
NPI:1154530665
Name:JACK COHN D.D.S.,P.A.
Entity type:Organization
Organization Name:JACK COHN D.D.S.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-598-1428
Mailing Address - Street 1:8970 SW 87TH CT STE 22
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2207
Mailing Address - Country:US
Mailing Address - Phone:305-598-1428
Mailing Address - Fax:305-598-5365
Practice Address - Street 1:8970 SW 87TH CT STE 22
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2207
Practice Address - Country:US
Practice Address - Phone:305-598-1428
Practice Address - Fax:305-598-5365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL 67481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty