Organization
COOPER DENTISTRY LLC
Active
Other names
Cooper Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
GIRIJA NADARAJAN (MANAGING MEMBER OWNER)
(480) 964-1000
Entity
Organization
Contact information
Practice address
78 N COOPER RD, SUITE 107, GILBERT, AZ 85233-5210
(480) 964-1000
(480) 964-3076
Mailing address
78 N COOPER RD, SUITE 107, GILBERT, AZ 85233-5210
(480) 964-1000
(480) 964-3076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1886358
UCCI
AZ
01
—
253383
DBP
AZ
01
—
75643
DHA
AZ
Enumeration date
05/03/2007
Last updated
08/22/2020
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