Organization
RUTGERS SCHOOL OF DENTAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAROLD COHEN DDS (DIRECTOR)
(973) 972-0214
Entity
Organization
Contact information
Practice address
110 BERGEN ST, NEWARK, NJ 07103-2495
(973) 972-0651
(073) 972-3164
Mailing address
110 BERGEN ST, NEWARK, NJ 07103-2495
(973) 972-0214
(973) 972-3164
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6045308
—
NJ
01
—
894120
MEDICARE GROUP NUMBER
NJ
Enumeration date
07/16/2007
Last updated
03/24/2014
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