| Benjamin Cooperman Dmd | |
|
25101 N Lake Pleasant Pkwy # B-1335 Peoria AZ 85383-1386 | |
| (480) 324-6457 | |
| (480) 680-0921 |
| Full Name | Benjamin Cooperman Dmd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 25101 N Lake Pleasant Pkwy # B-1335, Peoria, Arizona |
| Authorized Official Name and Position | Benjamin Peter Cooperman (OWNER) |
| Authorized Official Contact | 4803246457 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Cooperman Dmd 25101 N Lake Pleasant Pkwy # B-1335 Peoria AZ 85383-1386 Ph: (480) 324-6457 | Benjamin Cooperman Dmd 25101 N Lake Pleasant Pkwy # B-1335 Peoria AZ 85383-1386 Ph: (480) 324-6457 |
| NPI Number | 1417445099 |
|---|---|
| Provider Enumeration Date | 04/29/2018 |
| Last Update Date | 04/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417445099 | NPI | - | NPPES |
| 1225412950 | Other | AZ | NPI TYPE1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 9640 (Arizona) | Primary |
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