Individual
DR. JERIL RANSOM COOPER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4610 BRAINERD RD, SUITE 3, CHATTANOOGA, TN 37411-3836
(423) 622-4173
(423) 629-9889
Mailing address
4610 BRAINERD RD, SUITE 3, CHATTANOOGA, TN 37411-3836
(423) 622-4173
(423) 629-9889
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN012766
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DS8468
TN
Other
Enumeration date
11/17/2006
Last updated
11/15/2013
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