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Organization
JORDAN TODD COOPER DDS PA
Active
Organization
JORDAN TODD COOPER DDS PA
Active
Other names
Cooper Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN TODD COOPER DDS (PRESIDENT)
(501) 982-7547
Entity
Organization
Contact information
Practice address
308 N JAMES ST, JACKSONVILLE, AR 72076-4018
(501) 982-7547
(501) 985-8421
Mailing address
308 N JAMES ST, JACKSONVILLE, AR 72076-4018
(501) 982-7547
(501) 985-8421
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3565
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1874975
UNITED CONCORDIA
AR
01
—
638266
UNITED CONCORDIA
AR
Enumeration date
08/16/2011
Last updated
08/16/2011
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