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General NPI Number Information
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NPI Number | 1235668815
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Entity Type | Individual
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Provider Name | CAROLINE SPRUILL SCHOPPERT DMD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2017
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Last Update Date | 05/14/2019
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Provider Practice Location Address
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Address Line | 2415 VETERANS MEMORIAL PKWY
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City | TUSCALOOSA
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State | AL
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Zip | 35404-4137
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Country | US
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Telephone | 205-556-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 13629 OLD IVEY DR
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City | NORTHPORT
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State | AL
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Zip | 35475-3496
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Country | US
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Telephone | 205-393-2126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | D.6599-C1
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License Number State | AL
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