Jon Copeland DDS LLC
Clinic/Center, Dental in Wildwood, MO. Organization (NPI-2).
NPI number1164039558
StatusActive
Last updated in NPPESSep 29, 2020
Details
- NPI
- 1164039558
- Entity type
- Organization (NPI-2)
- Legal business name
- Jon Copeland DDS LLC
- Organization subpart
- No
- Enumeration date
- Sep 29, 2020
- Certification date
- Sep 29, 2020
- Last updated
- Sep 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Town Center Dental (Doing Business As)
Practice location
2426 Taylor RdWildwood, MO 63040-1222
Phone 636-273-5866
Mailing address
2426 Taylor RdWildwood, MO 63040-1222
Phone 636-273-5866
Authorized official
Tristan Wampler
Office Manager
6362735866
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