Individual
DR. JASON WILLIAM COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3506 VILLAGE CT, GARY, IN 46408-1428
(219) 985-3133
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8827
KY
Other
Enumeration date
09/24/2009
Last updated
12/28/2010
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