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General NPI Number Information
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NPI Number | 1225412950
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Entity Type | Individual
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Provider Name | BENJAMIN COOPERMAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 7422 E SAN JACINTO DR.
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-2906
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Country | US
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Telephone | 480-324-6457
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Fax |
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Provider Business Mailing Address
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Address Line | 7422 E SAN JACINTO DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-2096
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Country | US
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Telephone | 480-324-6457
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 6732
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9640
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License Number State | AZ
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