| Ronald H. Copenhaver Dmd Pa Advanced Center For Jaw Surgery | |
|
4338 1st Street N Suite C St. Petersburg FL 33703 | |
| (727) 822-2228 | |
| (727) 822-2441 |
| Full Name | Ronald H. Copenhaver Dmd Pa Advanced Center For Jaw Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4338 1st Street N, St. Petersburg, Florida |
| Authorized Official Name and Position | Ronald H. Copenhaver (OWNER) |
| Authorized Official Contact | 7278222228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald H. Copenhaver Dmd Pa Advanced Center For Jaw Surgery 4338 1st Street N Suite C St. Petersburg FL 33703 Ph: (727) 822-2228 | Ronald H. Copenhaver Dmd Pa Advanced Center For Jaw Surgery 4338 1st Street N Suite C St. Petersburg FL 33703 Ph: (727) 822-2228 |
| NPI Number | 1871730317 |
|---|---|
| Provider Enumeration Date | 01/20/2009 |
| Last Update Date | 07/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871730317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 6749 (Florida) | Primary |
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