Individual
DR. JERIL RANSOM COOPER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10621 HIGHWAY 11, TRENTON, GA 30752-3026
(706) 657-7561
(706) 675-8124
Mailing address
10621 HIGHWAY 11, TRENTON, GA 30752-3026
(706) 657-7561
(706) 675-8124
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8755
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00139598B
—
GA
05
—
00139598D
—
GA
05
—
ZG8755
—
SC
Enumeration date
06/12/2006
Last updated
07/18/2007
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