| Coperhaver Dental, Llc | |
|
10230 Ford Avenue Richmond Hill GA 31324-8854 | |
| (912) 756-2936 | |
| (912) 756-2931 |
| Full Name | Coperhaver Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10230 Ford Avenue, Richmond Hill, Georgia |
| Authorized Official Name and Position | Philip A Copenhaver (DENTIST/BUISINESS OWNER) |
| Authorized Official Contact | 9127562936 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coperhaver Dental, Llc 10230 Ford Avenue Richmond Hill GA 31324-8854 Ph: (912) 756-2936 | Coperhaver Dental, Llc 10230 Ford Avenue Richmond Hill GA 31324-8854 Ph: (912) 756-2936 |
| NPI Number | 1578836417 |
|---|---|
| Provider Enumeration Date | 02/22/2012 |
| Last Update Date | 02/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578836417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN012235 (Georgia) | Primary |
| 1223G0001X | Dentist - General Practice | DN013390 (Georgia) | Secondary |
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