KEVIN COPPELSON

LOS ANGELES, CA
NPI1225322019
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223S0112X Dentist Oral and Maxillofacial Surgery
(Licence: CA  101077)
Additional Taxonomies1223S0112X Dentist Oral and Maxillofacial Surgery
(Licence: TX  34607)
204E00000X Oral & Maxillofacial Surgery
(Licence: CA  157675)
204E00000X Oral & Maxillofacial Surgery
(Licence: TX  34607)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2011-06-08
Last Update Date2019-10-31
Business Address
KEVIN COPPELSON D.D.S., M.D.
10921 WILSHIRE BLVD STE 912
LOS ANGELES, CA 90024
Phone number: 310-579-9710
Mailing Address
KEVIN COPPELSON D.D.S., M.D.
10921 WILSHIRE BLVD STE 912
LOS ANGELES, CA 90024-3906
Phone number: 310-579-9710