Organization
KOPURI ORTHODONTIST PA
Active
Organization
KOPURI ORTHODONTIST PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. N RAO KOPURI B.D.S.,M.S. (PRESIDENT)
(321) 427-3000
Entity
Organization
Contact information
Practice address
1454 W INTERNATIONAL SPEEDWAY BLVD, DAYTONA BEACH, FL 32114-1442
(386) 947-2063
Mailing address
726 HAWKSBILL ISLAND DR, SATELLITE BEACH, FL 32937-3851
(321) 427-3000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN 10552
FL
Other
Enumeration date
04/27/2011
Last updated
04/27/2011
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