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
Phone: (360) 357-8075
Fax: (360) 357-3842
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104820901 | NPPES |
| Washington | MEDICAID | 5005459 |
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