Organization
E.W. COOPER D.D.S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNEST W COOPER (DENTIST)
(423) 928-2621
Entity
Organization
Contact information
Practice address
515 E WATAUGA AVE, JOHNSON CITY, TN 37601-4038
(423) 928-2621
Mailing address
515 EAST WATAUGA AVE, JOHNSON CITY, TN 37601-4038
(423) 928-2621
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
TN 3275
TN
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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