Cooper Mountain Dental LLC

NPI #1154726917 in Beaverton, Oregon

Provider Information

NPI Number: 1154726917
Entity Type: Organization
Organization Name: Cooper Mountain Dental LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 23, 2014
Last Updated: Oct 23, 2014

Practice Location

Address: 11471 SW SCHOLLS FERRY RD
City: Beaverton
State: Oregon
ZIP Code: 97008-7168
Phone: (503) 356-1078

Authorized Official

Name: DR. BANU RAMKRISHNA, DMD
Title: OWNER DENTIST
Phone: (503) 356-1078

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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