Individual
DR. KATHERINE S COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3606 WHEELER RD, AUGUSTA, GA 30909-6557
(706) 481-8811
Mailing address
3606 WHEELER RD, AUGUSTA, GA 30909-6557
(706) 481-8811
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
011383
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124458
UNITED CONCORDIA
GA
Enumeration date
06/14/2006
Last updated
07/08/2007
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