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Individual

DR. JONAH THOMAS COOPER-LEAVITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
512 MAIN ST E, SUITE 100, MONMOUTH, OR 97361-2369
(503) 837-0512
Mailing address
512 MAIN ST E, SUITE 100, MONMOUTH, OR 97361-2369
(503) 837-0512

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8326
OR

Other

Enumeration date
12/03/2007
Last updated
05/12/2010
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