Individual
DR. GARRISON EUGENE COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1775 GRAND CONCOURSE FL 6, BRONX, NY 10453-8202
(718) 992-7669
Mailing address
1276 FULTON AVE, BRONX, NY 10456-3402
(718) 992-7669
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
060920
NY
Other
Enumeration date
12/02/2011
Last updated
11/25/2020
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