Provider Demographics
NPI:1154624351
Name:COHEN, HENRY S (DMD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:S
Last Name:COHEN
Suffix:
Gender:M
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:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:CENTRAL VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10917
Mailing Address - Country:US
Mailing Address - Phone:845-928-2205
Mailing Address - Fax:845-928-7801
Practice Address - Street 1:287 RT 32
Practice Address - Street 2:
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917
Practice Address - Country:US
Practice Address - Phone:845-928-2205
Practice Address - Fax:845-928-7801
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0294261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice