Organization
MICHAEL W. COOPER, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W. COOPER D.D.S. (OWNER)
(479) 968-4477
Entity
Organization
Contact information
Practice address
110 S INGLEWOOD AVE, RUSSELLVILLE, AR 72801-3353
(479) 968-4477
(479) 968-4498
Mailing address
110 S INGLEWOOD AVE, RUSSELLVILLE, AR 72801-3353
(479) 968-4477
(479) 968-4498
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2569
AR
Other
Enumeration date
11/10/2006
Last updated
08/22/2020
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