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Organization

MICHAEL R COPPE DMD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL RICHARD COPPE (DMD)
(781) 861-6120
Entity
Organization

Contact information

Practice address
19 MUZZEY ST, SUITE 6, LEXINGTON, MA 02421-5256
(781) 861-6120
Mailing address
19 MUZZEY ST, SUITE 6, LEXINGTON, MA 02421-5256

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
11347
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0207772
MA
01
1639264435
NPI
MA
Enumeration date
02/09/2011
Last updated
02/09/2011
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