Individual
DR. TIMOTHY DALE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
825 E MAIN ST, MANCHESTER, IA 52057
(563) 927-5415
(563) 927-3542
Mailing address
825 E MAIN ST, MANCHESTER, IA 52057
(563) 927-5415
(563) 927-3542
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6556
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0500074
—
IA
Enumeration date
01/30/2007
Last updated
07/08/2007
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