Organization
JERRY E COOPER DDS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY EDWARD COOPER D.D.S. (PRESIDENT)
(920) 452-1110
Entity
Organization
Contact information
Practice address
1407 N 8TH ST, SHEBOYGAN, WI 53081-3400
(920) 452-1110
(920) 452-1996
Mailing address
1407 N 8TH ST, SHEBOYGAN, WI 53081-3400
(920) 452-1110
(920) 452-1996
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6314-015
WI
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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