MEDICARE: DR. NAOMI DAKOTA COOPER D.D.S.

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
1	1223G0001X	General Practice Dentistry	25775	TX

General Provider Information

NPI Number	:	1740594191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAOMI DAKOTA COOPER D.D.S.

Provider Business Mailing Address
First Line	:	2213 HARWOOD RD
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-3607
Country	:	US
Telephone Number	:	817-354-9999
Fax Number	:	817-354-1301

Provider Business Practice Location Address
First Line	:	2213 HARWOOD RD
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-3607
Country	:	US
Telephone Number	:	817-354-9999
Fax Number	:	817-354-1301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2010
Last Update Date	:	10/05/2022

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