# KEITH M COOPER DDS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386249829
- **Authorized official:** KIETH COOPER DDS (OWNER)
- **Authorized official phone:** (408) 253-4150

## Contact information

- **Practice address:** 5150 GRAVES AVE STE 12E, SAN JOSE, CA 95129-5015
- **Practice address phone:** (408) 253-4150
- **Practice address fax:** (408) 253-1979
- **Mailing address:** 5150 GRAVES AVE STE 12E, SAN JOSE, CA 95129-5015
- **Mailing address phone:** (408) 253-4150
- **Mailing address fax:** (408) 253-1979

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | — | NULL | Yes |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 12/02/2020
- **Last updated:** 12/02/2020