Organization
JAMES M. COOPER, D.D.S., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN M. VANN (OFFICE MANAGER)
(501) 982-7547
Entity
Organization
Contact information
Practice address
308 NORTH JAMES STREET, JACKSONVILLE, AR 72076-4018
(501) 982-7547
(507) 985-8421
Mailing address
308 NORTH JAMES STREET, JACKSONVILLE, AR 72076-4018
(501) 982-7547
(507) 985-8421
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2008
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1874975
UNITED CONCORDIA
AR
01
—
58159
ARKANSAS BCBS IND #
AR
01
—
5F573
ARKANSAS BCBS GROUP #
AR
01
—
5Y893
ARKANSAS BCBS IND #
AR
01
—
638266
UNITED CONCORDIA
AR
Enumeration date
04/23/2007
Last updated
08/11/2011
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