Individual
DR. JONATHAN M COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2426 TAYLOR RD, WILDWOOD, MO 63040-1222
(636) 273-5866
(636) 273-5349
Mailing address
16545 WILLOW GLEN DR, WILDWOOD, MO 63040-1748
(636) 273-5866
(636) 273-5349
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2009013176
MO
Other
Enumeration date
12/07/2009
Last updated
08/29/2013
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