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General NPI Number Information
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NPI Number | 1346497492
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Entity Type | Organization
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Legal Business Name | LESLIE P COONER DDS PA
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 10220 W MARKHAM ST SUITE 120
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2189
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Country | US
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Telephone | 501-227-6226
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Fax | 501-227-6295
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Provider Business Mailing Address
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Address Line | 10220 W MARKHAM ST SUITE 120
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2189
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Country | US
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Telephone | 501-227-6226
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Fax | 501-227-6295
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LESLIE P COONER
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Credential | DDS
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Telephone | 501-227-6226
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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 | 2805
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License Number State | AR
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