Organization
JORDAN TODD COOPER DDS PA
Active
Other names
Cooper Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN TODD COOPER DDS (PRESIDENT)
(501) 982-7547
Entity
Organization
Contact information
Practice address
308 N JAMES ST, JACKSONVILLE, AR 72076-4018
(501) 982-7547
(501) 985-8421
Mailing address
308 N JAMES ST, JACKSONVILLE, AR 72076-4018
(501) 982-7547
(501) 985-8421
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3565
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1874975
UNITED CONCORDIA
AR
01
—
638266
UNITED CONCORDIA
AR
Enumeration date
08/16/2011
Last updated
08/16/2011
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