Cooper, Sean A
Cooper, Sean A is an sole proprietor health care provider with primary practice located at 1105 12Th St Se , Salem OR 97302-2810. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Cooper, Sean A can be contacted via phone (503) 363-5865.Contact Information
Primary practice address
1105 12Th St Se
Salem OR 97302-2810
Phone: (503) 363-5865
Fax: (503) 363-8510
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | D7375 | Oregon |
Profile Details
| NPI number | 1457376782 |
|---|---|
| LBN Legal business name | Cooper, Sean A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Apr 26th, 2012 - about 13 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 | 1457376782 | NPPES |
| Oregon | MEDICAID | 150611 |
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