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General NPI Number Information
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NPI Number | 1659449775
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Entity Type | Individual
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Provider Name | KEVIN C KOPP DDS
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 188 N YORK RD
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 630-941-8398
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Fax | 630-941-8408
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Provider Business Mailing Address
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Address Line | 188 N YORK RD
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 630-941-8398
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Fax | 630-941-8408
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 190196599
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License Number State | IL
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