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General NPI Number Information
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NPI Number | 1588233548
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Entity Type | Organization
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Legal Business Name | COOPER ORTHODONTICS, LLC
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 1718 N FEDERAL HWY
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City | LAKE WORTH
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State | FL
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Zip | 33460-6643
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Country | US
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Telephone | 561-588-0319
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Fax | 561-790-4477
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Provider Business Mailing Address
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Address Line | 685 ROYAL PALM BEACH BLVD STE 202
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-7642
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Country | US
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Telephone | 561-790-0319
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Fax | 561-790-4477
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Authorized Official
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Title or Position | ORTHODONTICS
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Name | DR. ANDREW COOPER
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Credential | DMD
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Telephone | 561-790-0319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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