| Jerry E Cooper DDS, SC | |
|
1407 N 8th St Sheboygan WI 53081-3400 | |
| (920) 452-1110 | |
| (920) 452-1996 |
| Full Name | Jerry E Cooper DDS, SC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1407 N 8th St, Sheboygan, Wisconsin |
| Authorized Official Name and Position | Jerry Edward Cooper (PRESIDENT) |
| Authorized Official Contact | 9204521110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry E Cooper DDS, SC 1407 N 8th St Sheboygan WI 53081-3400 Ph: (920) 452-1110 | Jerry E Cooper DDS, SC 1407 N 8th St Sheboygan WI 53081-3400 Ph: (920) 452-1110 |
| NPI Number | 1265730287 |
|---|---|
| Provider Enumeration Date | 03/01/2011 |
| Last Update Date | 03/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265730287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 6314-015 (Wisconsin) | Primary |
David Blong S Lee DDS SC Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 825 Michigan Ave, Sheboygan, WI 53081 Phone: 920-459-9010 Fax: 920-459-9272 |
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