Cooper Creek Dental, LLC

NPI #1679978894 in University Park, Florida

Provider Information

NPI Number: 1679978894
Entity Type: Organization
Organization Name: Cooper Creek Dental, LLC
Primary Specialty: Dentist
Enumeration Date: Oct 30, 2014
Last Updated: Oct 30, 2014

Practice Location

Address: 8460 COOPER CREEK BLVD
Address 2: SUITE 103
City: University Park
State: Florida
ZIP Code: 34201-2019
Phone: (941) 366-1010

Authorized Official

Name: DR. SHELLY DONEGAN MCAVOY, DME
Title: PRESIDENT
Phone: (941) 366-1010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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