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General NPI Number Information
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NPI Number | 1649919580
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Entity Type | Organization
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Legal Business Name | COOPER DENTAL INC
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 611 S WHITE HORSE PIKE
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City | LINDENWOLD
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State | NJ
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Zip | 08021-2325
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Country | US
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Telephone | 856-282-0044
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Fax |
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Provider Business Mailing Address
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Address Line | 3 CRESTHILL CT
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City | VOORHEES
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State | NJ
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Zip | 08043-2832
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Country | US
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Telephone | 856-248-0404
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OMAR ALDOORI
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Credential | DMD
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Telephone | 856-248-0404
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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 |
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License Number State |
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