# JON COPELAND DDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Town Center Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164039558
- **Authorized official:** MS. TRISTAN WAMPLER (OFFICE MANAGER)
- **Authorized official phone:** (636) 273-5866

## Contact information

- **Practice address:** 2426 TAYLOR RD, WILDWOOD, MO 63040-1222
- **Practice address phone:** (636) 273-5866
- **Mailing address:** 2426 TAYLOR RD, WILDWOOD, MO 63040-1222
- **Mailing address phone:** (636) 273-5866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/29/2020
- **Last updated:** 09/29/2020