Organization
COPERHAVER DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP A COPENHAVER D.D.S (DENTIST/BUISINESS OWNER)
(912) 756-2936
Entity
Organization
Contact information
Practice address
10230 FORD AVENUE, RICHMOND HILL, GA 31324-8854
(912) 756-2936
(912) 756-2931
Mailing address
10230 FORD AVENUE, RICHMOND HILL, GA 31324-8854
(912) 756-2936
(912) 756-2931
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012235
GA
1223G0001X
General Practice Dentistry
DN013390
GA
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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