Individual
MR. JESSE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 STATE ST, JOHNSTOWN, PA 15905-2758
(814) 255-7181
Mailing address
1377 VARNER LN, JOHNSTOWN, PA 15909-1329
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS045122
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2025
Last updated
06/20/2025
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