Individual
DR. JASON RYAN COOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
203 S DIXIE HWY, CAVE CITY, KY 42127-8866
(270) 773-3943
(270) 773-3944
Mailing address
203 S DIXIE HWY, CAVE CITY, KY 42127-8866
(270) 773-3943
(270) 773-3944
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7869
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60001435
—
KY
Enumeration date
01/18/2007
Last updated
07/08/2007
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