Provider Demographics
NPI:1093866683
Name:COOPER, LOUIS M (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:M
Last Name:COOPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 POLLY PK RD
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-1949
Mailing Address - Country:US
Mailing Address - Phone:914-697-4151
Mailing Address - Fax:
Practice Address - Street 1:90 S RIDGE ST
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2867
Practice Address - Country:US
Practice Address - Phone:914-925-1099
Practice Address - Fax:914-934-8942
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0318211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry