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NPI Code Detail

MEDICARE: CONSTANCE COPETAS DMD

MEDICARE: CONSTANCE COPETAS DMD
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
1122300000XDentist5785WA

General Provider Information

NPI Number : 1932654266
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONSTANCE COPETAS DMD
Provider Business Mailing Address
First Line : 104 W 5TH AVE STE 290E
Second Line :
City : SPOKANE
State : WA
Zip : 99204-4812
Country : US
Telephone Number : 509-747-5586
Fax Number : 509-624-9288
Provider Business Practice Location Address
First Line : 104 W 5TH AVE STE 290E
Second Line :
City : SPOKANE
State : WA
Zip : 99204-4812
Country : US
Telephone Number : 509-747-5586
Fax Number : 509-624-9288
Authorized Official
Title or Position : OWNER / DENTIST
Name : DR. CONSTANCE C COPETAS
Credential : DMD
Telephone Number : 509-747-5586
Provider Enumeration Date : 08/16/2016
Last Update Date : 08/16/2016

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Directions to “CONSTANCE COPETAS DMD ” Practice Location

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