Organization
MANCHESTER DENTAL DC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIM D COOPER DDS (PRESIDENT OWNER)
(563) 927-5415
Entity
Organization
Contact information
Practice address
825 E MAIN ST, MANCHESTER, IA 52057
(563) 927-5415
(563) 927-3542
Mailing address
825 E MAIN ST, MANCHESTER, IA 52057
(563) 927-5415
(563) 927-3542
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
06556
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0500074
—
IA
Enumeration date
10/31/2006
Last updated
08/22/2020
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