Healthcare Provider Details

I. General information

NPI: 1184936726
Provider Name (Legal Business Name): CRAIG FLEMING COPELAND D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2628 MATLOCK RD
ARLINGTON TX
76015-2525
US

IV. Provider business mailing address

2628 MATLOCK RD
ARLINGTON TX
76015-2525
US

V. Phone/Fax

Practice location:
  • Phone: 940-220-7833
  • Fax:
Mailing address:
  • Phone: 817-468-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number25735
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: