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Organization
RICK COFER JR DDS PA
Active
Organization
RICK COFER JR DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK E COFER JR. DDS (DENTIST)
(254) 732-0309
Entity
Organization
Contact information
Practice address
5400 CROSSLAKE PKWY, SUITE 400, WACO, TX 76712-6977
(254) 732-0309
(254) 732-0229
Mailing address
5400 CROSSLAKE PKWY, SUITE 400, WACO, TX 76712-6977
(254) 732-0309
(254) 732-0229
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16764
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
292392201
TEXAS PROVIDER IDENTIFICATION
TX
01
—
88D951
BCBS
—
Enumeration date
10/05/2006
Last updated
06/02/2016
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