Cooley, David Fenton
Cooley, David Fenton is an sole proprietor health care provider with primary practice located at 5108 Lovers Ln Suite D, Portage MI 49002-1558. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Cooley, David Fenton can be contacted via phone (269) 345-1021.Contact Information
Primary practice address
5108 Lovers Ln Suite D
Portage MI 49002-1558
Phone: (269) 345-1021
Fax: (269) 345-0948
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 096850 | Michigan |
Profile Details
| NPI number | 1952440356 |
|---|---|
| LBN Legal business name | Cooley, David Fenton |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 5th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952440356 | NPPES |
| Michigan | Other | 096850 | MICHIGAN PROVIDER ID |
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