DR. Mark Allen Cooper, DDS

NPI #1912926411 in Clearlake, California

Provider Information

NPI Number: 1912926411
Entity Type: Individual
Name: DR. Mark Allen Cooper, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 18, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 3560 OLD HIGHWAY 53
City: Clearlake
State: California
ZIP Code: 95422-9251
Phone: (707) 994-9414

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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