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Individual

DR. LYNDON COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MS, PHD

Contact information

Practice address
801 S PAULINA ST # 402E, CHICAGO, IL 60612-7210
(312) 996-7515
Mailing address
415 E NORTH WATER ST APT 607, CHICAGO, IL 60611-5613
(919) 649-7531

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.030537
IL
1223P0700X
Prosthodontics
0007
NC
1223P0700X
Prosthodontics
Primary
021.002815
IL
1223P0700X
Prosthodontics
38430-1
NY

Other

Enumeration date
03/20/2007
Last updated
01/14/2020
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