Individual
DR. AVANTHI KOPURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D., M.S.D.
Contact information
Practice address
2555 W NEW HAVEN AVE, MELBOURNE, FL 32904-3701
(321) 728-9999
Mailing address
2555 W NEW HAVEN AVE, MELBOURNE, FL 32904-3701
(321) 728-9999
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN19053
FL
Other
Enumeration date
09/06/2014
Last updated
01/01/2020
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