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General NPI Number Information
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NPI Number | 1093866683
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Entity Type | Individual
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Provider Name | LOUIS M COOPER DDS
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 03/25/2011
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Provider Practice Location Address
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Address Line | 90 S RIDGE ST
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City | RYE BROOK
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State | NY
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Zip | 10573-2867
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Country | US
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Telephone | 914-925-1099
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Fax | 914-934-8942
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Provider Business Mailing Address
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Address Line | 165 POLLY PK RD
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City | RYE
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State | NY
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Zip | 10580-1949
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Country | US
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Telephone | 914-697-4151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 031821
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License Number State | NY
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