MEDICARE: DOUGLAS E JOPLING D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	15801	TX

General Provider Information

NPI Number	:	1487871992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS E JOPLING D.D.S.

Provider Business Mailing Address
First Line	:	5200 VILLAGE CREEK DR STE 101
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-4429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5200 VILLAGE CREEK DR STE 101
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-4429
Country	:	US
Telephone Number	:	972-733-3338
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/08/2007

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