Individual
MICHAEL RICHARD COPPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
21 MUZZEY ST STE 6, LEXINGTON, MA 02421-5259
(781) 861-6120
(781) 861-7856
Mailing address
21 MUZZEY ST STE 6, LEXINGTON, MA 02421-5259
(781) 861-6120
(781) 861-7856
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
—
380040
HARVARD PILGRIM HEALTH CA
MA
01
—
524035
TRICARE - TDP
MA
01
—
X12381
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/04/2006
Last updated
05/09/2018
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