Cooper Mountain Dental Llc

NPI 1154726917 - Dentist - 1223G0001X

NPI Details
NPI 1154726917
Enumeration Date 10/23/2014
Last Updated 10/23/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name BANU BANU
Position OWNER DENTIST
Phone (503) 356-1078
Fax
Practice Location
11471 SW SCHOLLS FERRY RD
BEAVERTON OR, 97008-7168, US
Phone (503) 356-1078
Fax
Business Location
11471 SW SCHOLLS FERRY RD
BEAVERTON OR, 97008-7168, US
Phone
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Oregon
License Number D8822
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According to our database, Cooper Mountain Dental Llc NPI is 1154726917, taxonomy code is 1223G0001X and license number is D8822, license state is located at Oregon. Cooper Mountain Dental Llc physically located at 11471 Sw Scholls Ferry Rd, Beaverton OR, 97008-7168. NPI Number 1033115704 has the healthcare provider type.

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1154726917 NPI number is provided on an as is basis without warranty of any kind. 1154726917 is maintained by the National Plan & Provider Enumeration System. The contents of Cooper Mountain Dental Llc are for informational purposes only.