Provider Demographics
NPI:1043952088
Name:ANTHONY M. COPE DDS, PC
Entity Type:Organization
Organization Name:ANTHONY M. COPE DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-359-2308
Mailing Address - Street 1:9602 E WASHINGTON ST STE D
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-3060
Mailing Address - Country:US
Mailing Address - Phone:317-359-2308
Mailing Address - Fax:317-359-0010
Practice Address - Street 1:9602 E WASHINGTON ST STE D
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-3060
Practice Address - Country:US
Practice Address - Phone:317-359-2308
Practice Address - Fax:317-359-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200220240AMedicaid