Individual
DR. IRA D. KOEPPEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
126 GNARLED HOLLOW RD, EAST SETAUKET, NY 11733-1975
(631) 689-9777
(631) 689-2108
Mailing address
126 GNARLED HOLLOW RD, EAST SETAUKET, NY 11733-1975
(631) 689-9777
(631) 689-2108
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
038668-1
NY
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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