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General NPI Number Information
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NPI Number | 1972627438
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Entity Type | Organization
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Legal Business Name | N.RAO KOPURI, BDS.,MS.,PA.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 780 E MERRITT ISLAND CSWY SUITE 6 C
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-3562
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Country | US
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Telephone | 321-453-5833
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Fax | 321-453-3633
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Provider Business Mailing Address
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Address Line | 780 E MERRITT ISLAND CSWY SUITE 6 C
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-3562
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Country | US
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Telephone | 321-453-5833
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Fax | 321-453-3633
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. N RAO KOPURI
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Credential | BDS.,MS.
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Telephone | 321-427-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | P00000094134
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License Number State | FL
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