Organization
COOPER ORAL & MAXILLOFACIAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSEY W. COOPER SR. DMD (OWNER/PRESIDENT)
(615) 320-1392
Entity
Organization
Contact information
Practice address
207 TWENTY THIRD AVENUE NORTH, NASHVILLE, TN 37203-1501
(615) 320-1392
(615) 329-4245
Mailing address
207 TWENTY THIRD AVENUE NORTH, NASHVILLE, TN 37203-1501
(615) 320-1392
(615) 329-4245
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3032
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS3032
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS4607
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS7219
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006315
BCBST TIMOTHY D PROVENCE
TN
01
—
2009819
BCBST LINDSEY W COOPER
TN
01
—
3141185
BCBST SPENCER A HALEY
TN
Enumeration date
04/10/2007
Last updated
10/13/2010
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