William F Cooper, D.D.S.

Individual provider Active NPI Periodontics · Labelle, FL

NPI 1083727242 · NPPES record last updated Nov 12, 2009

Key facts

NPI
1083727242
Entity type
Individual (NPI type 1)
Primary specialty
Periodontics 1223P0300X
License
4926 (FL)
Practice address
813 E Hickpochee Ave
Suite 500
Labelle, FL 33935-5033
Phone
(863) 675-3270
Fax
(863) 675-3868
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4926FLMDSpeech-Language Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 4926 FL Yes

Addresses

Primary practice location

813 E Hickpochee Ave
Suite 500
Labelle, FL 33935-5033

Mailing address

813 E Hickpochee Ave
Suite 500
Labelle, FL 33935-5033
Phone (863) 675-3270

Other providers in Labelle, FL

All providers in Labelle, FL · Periodontics in Florida

Sources for this page

Verify at the official NPI Registry.