Individual
DR. BEN COOPER JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
550 POND VIEW DR STE 2, NORTH LIBERTY, IA 52317
(319) 459-1975
(319) 459-1977
Mailing address
322 DENTAL SCIENCE S, IOWA CITY, IA 52242-1001
(319) 384-1139
(319) 384-1785
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
09095
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649521121
LHI
IA
Enumeration date
09/25/2012
Last updated
04/23/2019
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