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General NPI Number Information
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NPI Number | 1396166393
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Entity Type | Organization
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Legal Business Name | KOPPELMAN DENTAL
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Dates
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Enumeration Date | 12/18/2013
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 7 WEST 45TH STREET 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10036
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Country | US
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Telephone | 212-382-3782
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Fax |
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Provider Business Mailing Address
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Address Line | 7 W 45TH ST FL 2
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City | NEW YORK
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State | NY
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Zip | 10036-4921
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DDS
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Name | DR. PAUL KOPPELMAN
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Credential |
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Telephone | 212-382-3782
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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 | 0350311
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License Number State | NY
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