Organization
MODERN ORTHODONTICS, PC
Active
Other names
Kenneth Cooperman, DMD, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH BRUCE COOPERMAN DMD (OWNER)
(718) 993-5454
Entity
Organization
Contact information
Practice address
391 E 149TH ST RM 214, BRONX, NY 10455-3922
(718) 993-5454
(718) 993-5455
Mailing address
391 E 149TH ST RM 214, BRONX, NY 10455-3922
(718) 993-5454
(718) 993-5455
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0469571
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200698105
—
NY
Enumeration date
04/20/2006
Last updated
05/14/2024
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