Organization
A CHOICE DENTAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT EARL COOPER DMD (CEO)
(502) 895-1171
Entity
Organization
Contact information
Practice address
111 FAIRFAX AVE, LOUISVILLE, KY 40207-4905
(502) 895-1171
(502) 899-7197
Mailing address
111 FAIRFAX AVE, LOUISVILLE, KY 40207-4905
(502) 895-1171
(502) 899-7197
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5765
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015370
—
KY
Enumeration date
04/12/2007
Last updated
08/22/2020
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