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General NPI Number Information
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NPI Number | 1063630341
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Entity Type | Organization
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Legal Business Name | JAMES M. COOPER, D.D.S., PA
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 308 NORTH JAMES STREET
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City | JACKSONVILLE
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State | AR
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Zip | 72076-4018
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Country | US
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Telephone | 501-982-7547
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Fax | 507-985-8421
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Provider Business Mailing Address
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Address Line | 308 NORTH JAMES STREET
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City | JACKSONVILLE
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State | AR
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Zip | 72076-4018
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Country | US
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Telephone | 501-982-7547
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Fax | 507-985-8421
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARILYN M. VANN
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Credential |
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Telephone | 501-982-7547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2008
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License Number State | AR
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