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Organization
KEVIN C COOPER DDS PC
Active
Organization
KEVIN C COOPER DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN C COOPER DDS (PRESIDENT)
(757) 483-5152
Entity
Organization
Contact information
Practice address
3105 WESTERN BRANCH BLVD, SUITE 5, CHESAPEAKE, VA 23321-5543
(757) 483-5152
(757) 483-7711
Mailing address
3105 WESTERN BRANCH BLVD, SUITE 5, CHESAPEAKE, VA 23321-5543
(757) 483-5152
(757) 483-7711
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007725
DORAL DENTAL
VA
Enumeration date
04/29/2008
Last updated
04/29/2008
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