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NPI Code Detail

MEDICARE: MICHAEL J COONEY DDS

MEDICARE: MICHAEL J COONEY DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry22722TX

General Provider Information

NPI Number : 1689881286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J COONEY DDS
Provider Business Mailing Address
First Line : 506 N HEWITT DR
Second Line :
City : HEWITT
State : TX
Zip : 76643-3038
Country : US
Telephone Number : 254-666-1686
Fax Number : 254-666-9252
Provider Business Practice Location Address
First Line : 506 N HEWITT DR
Second Line :
City : HEWITT
State : TX
Zip : 76643-3038
Country : US
Telephone Number : 254-666-1686
Fax Number : 254-666-9252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 07/08/2007

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