Provider Demographics
NPI:1710206149
Name:COOPER, ANDREW D (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:COOPER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:685 ROYAL PALM BEACH BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-7642
Mailing Address - Country:US
Mailing Address - Phone:561-790-0319
Mailing Address - Fax:
Practice Address - Street 1:685 ROYAL PALM BEACH BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-7642
Practice Address - Country:US
Practice Address - Phone:561-790-0319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN183791223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics