Organization
GEORGE R. COOPER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY C STONE (OFFICE ASSOCIATE)
(260) 489-1508
Entity
Organization
Contact information
Practice address
2121 E DUPONT RD STE E, FORT WAYNE, IN 46825-1546
(260) 489-1508
(260) 338-2541
Mailing address
2121 E DUPONT RD STE E, FORT WAYNE, IN 46825-1546
(260) 489-1508
(260) 338-2541
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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