Cooper, Philip Wendell
Cooper, Philip Wendell is an sole proprietor health care provider with primary practice located at 413 W Duffy St , Savannah GA 31401-6716. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Cooper, Philip Wendell can be contacted via phone (912) 234-5003.Contact Information
Primary practice address
413 W Duffy St
Savannah GA 31401-6716
Phone: (912) 234-5003
Fax: (912) 234-2844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | GA8412 | Georgia |
Profile Details
| NPI number | 1922165075 |
|---|---|
| LBN Legal business name | Cooper, Philip Wendell |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 1st, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1922165075 | NPPES |
| Georgia | Other | GA8412 | LICENSE |
| Georgia | MEDICAID | 00045251A | LICENSE |
| Georgia | Other | 9184118 | LICENSE |
| Georgia | MEDICAID | ZAG994 | LICENSE |
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