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Organization
JACK D COOPER
Active
Organization
JACK D COOPER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA C KOBS (OFFICE MANAGER)
(402) 944-3305
Entity
Organization
Contact information
Practice address
705 N 17TH AVE, ASHLAND, NE 68003-1209
(402) 944-3305
(402) 944-7611
Mailing address
705 N 17TH AVE, ASHLAND, NE 68003-1209
(402) 944-3305
(402) 944-7611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4005
NE
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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