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Contact Information

TODD C COOPER, DDS
512 N YOUNG ST
KENNEWICK, WA99336-7806
 Phone: 509-783-7600
 Fax: 509-783-0774
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for TODD C COOPER · (Male)

NPI Number 1871523183
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 07/03/2006
Last updated 11/25/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • OR License # D9191
  • WA License # 9520
  • WA Medicaid 5042361
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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