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Individual

DEVON COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5495 N BEND RD STE 102, BURLINGTON, KY 41005-9378
(859) 534-5460
Mailing address
1560 3RD ST APT 903, SAN FRANCISCO, CA 94158-2314

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10073
KY

Other

Enumeration date
05/03/2018
Last updated
05/03/2018
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