NPI | 1518047885 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN MATTHEW KOPP Co Owner 502-231-6474 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 7365) |
Enumeration Date | 2006-10-17 |
Last Update Date | 2020-08-22 |