Organization
MODERN ORTHODONTICS, PC
Active
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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