Cooper, Bruce E

Cooper, Bruce E is an individual health care provider with primary practice located at 1105 4Th Ave E Ste A, Olympia WA 98506-4018. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Cooper, Bruce E can be contacted via phone (360) 357-8075.

Contact Information

Primary practice address
1105 4Th Ave E Ste A Olympia WA 98506-4018
Fax: (360) 357-3842
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DE00006116 Washington

Profile Details

NPI number 1104820901
LBN Legal business name Cooper, Bruce E
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Jun 26th, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104820901 NPPES
Washington MEDICAID 5005459

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