Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 30023136 | OH |
NPI | 1225364326 |
---|---|
Provider Name | Valerie Elaine Cooper |
First Address | Dayton, OH 45459-7010 |
Second Address | Dayton, OH 45459-7010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2009 |
Last Update Date | 28/04/2011 |