| Kopuri Orthodontist Pa | |
|
1454 W International Speedway Blvd Daytona Beach FL 32114-1442 | |
| (386) 947-2063 | |
| Not Available |
| Full Name | Kopuri Orthodontist Pa |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1454 W International Speedway Blvd, Daytona Beach, Florida |
| Authorized Official Name and Position | N Rao Kopuri (PRESIDENT) |
| Authorized Official Contact | 3214273000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kopuri Orthodontist Pa 726 Hawksbill Island Dr Satellite Beach FL 32937-3851 Ph: (321) 427-3000 | Kopuri Orthodontist Pa 1454 W International Speedway Blvd Daytona Beach FL 32114-1442 Ph: (386) 947-2063 |
| NPI Number | 1699066415 |
|---|---|
| Provider Enumeration Date | 04/27/2011 |
| Last Update Date | 04/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699066415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DN 10552 (Florida) | Primary |
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