Individual
DR. SEAN A COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1105 12TH ST SE, SALEM, OR 97302-2810
(503) 363-5865
(503) 363-8510
Mailing address
1105 12TH ST SE, SALEM, OR 97302-2810
(503) 363-5865
(503) 363-8510
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D7375
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150611
—
OR
Enumeration date
07/13/2006
Last updated
04/26/2012
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