Provider Demographics
NPI:1851334023
Name:COONER, LESLIE PURIFOY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:PURIFOY
Last Name:COONER
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 1:10220 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2184
Mailing Address - Country:US
Mailing Address - Phone:501-227-6226
Mailing Address - Fax:501-227-6295
Practice Address - Street 1:10220 W MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2189
Practice Address - Country:US
Practice Address - Phone:501-227-6226
Practice Address - Fax:501-227-6295
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR28051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice