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Individual

WILLIAM K. KOPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
79 01 BROADWAY, ROOM A1-9, ELMHURST, NY 11373-1329
(718) 334-4952
(718) 334-4815
Mailing address
79 01 BROADWAY, ROOM A1-9, ELMHURST, NY 11373-1329
(718) 334-4952
(718) 334-4815

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
024056
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00287458
NY
Enumeration date
06/27/2006
Last updated
07/08/2007
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