Provider Demographics
NPI:1881810265
Name:COOPERMAN, ALAN M (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:COOPERMAN
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 1:44215 15TH ST W STE 313
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5505
Mailing Address - Country:US
Mailing Address - Phone:661-948-2721
Mailing Address - Fax:661-948-4055
Practice Address - Street 1:44215 15TH ST W STE 313
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5505
Practice Address - Country:US
Practice Address - Phone:661-948-2721
Practice Address - Fax:661-948-4055
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373241223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics