Individual
DR. COOPER DIFFERDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
10 WILLOW ST, MILL VALLEY, CA 94941-2845
(415) 388-6100
(415) 388-6100
Mailing address
10 WILLOW ST STE 6, MILL VALLEY, CA 94941-2895
(415) 388-6100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
64885
CA
Other
Enumeration date
05/17/2016
Last updated
03/17/2018
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