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General NPI Number Information
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NPI Number | 1053836619
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Entity Type | Organization
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Legal Business Name | AUSTIN COPE DMD LLC
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4650 WEDEKIND RD STE 1
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City | SPARKS
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State | NV
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Zip | 89431-7722
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Country | US
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Telephone | 775-356-8254
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Fax | 775-356-1446
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Provider Business Mailing Address
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Address Line | 4650 WEDEKIND RD STE 1
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City | SPARKS
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State | NV
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Zip | 89431-7722
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Country | US
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Telephone | 775-356-8254
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Fax | 775-356-1446
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Authorized Official
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Title or Position | OWNER
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Name | AUSTIN COPE
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Credential | DMD
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Telephone | 916-220-7620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6865
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License Number State | NV
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