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General NPI Number Information
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NPI Number | 1902584964
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Entity Type | Organization
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Legal Business Name | ASHLEY & BENJAMIN KOPPEL DDS INC
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 620 S MELROSE DR STE 201
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City | VISTA
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State | CA
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Zip | 92081-6644
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Country | US
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Telephone | 760-554-8825
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Fax |
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Provider Business Mailing Address
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Address Line | 490 MORAGA WAY
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City | OCEANSIDE
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State | CA
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Zip | 92058-7998
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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 | CEO
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Name | DR. ASHLEY ANN-ROBBINS KOPPEL
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Credential | DDS
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Telephone | 760-554-8825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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