Individual
DR. JENNIFER COOPER DUDOVITZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
28655 HOOVER RD, WARREN, MI 48093-4105
(586) 751-0400
Mailing address
10494 LUDLOW AVE, HUNTINGTON WOODS, MI 48070-1524
(248) 543-9486
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003920
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E06683
BCBS
MI
Enumeration date
06/18/2006
Last updated
07/08/2007
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