| 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 |