# RONALD H COPENHAVER DMD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ronald H. Copenhaver DMD PA Advanced Center For Jaw Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871730317
- **Authorized official:** DR. RONALD H. COPENHAVER D.M.D., (OWNER)
- **Authorized official phone:** (727) 822-2228

## Contact information

- **Practice address:** 4338 1ST STREET N, SUITE C, ST. PETERSBURG, FL 33703
- **Practice address phone:** (727) 822-2228
- **Practice address fax:** (727) 822-2441
- **Mailing address:** 4338 1ST STREET N, SUITE C, ST. PETERSBURG, FL 33703
- **Mailing address phone:** (727) 822-2228
- **Mailing address fax:** (727) 822-2441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 6749 | FL | Yes |

## Other

- **Enumeration date:** 01/20/2009
- **Last updated:** 07/13/2010