Individual
JENNIFER S COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1275 W GRANADA BLVD, SUITE 1, ORMOND BEACH, FL 32174-8259
(386) 672-0955
(386) 672-5177
Mailing address
1275 WEST GRANADA BLVD., SUITE 1, ORMOND BEACH, FL 32174
(386) 672-0955
(386) 672-5177
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 12068
FL
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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