Individual
DR. GEOFFREY ROBERT KOPECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3820 CONVOY ST, SAN DIEGO, CA 92111-3722
(858) 569-1100
Mailing address
PO BOX 675667, RANCHO SANTA FE, CA 92067-5667
(858) 259-1669
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30831
CA
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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