Provider Demographics
NPI:1093170284
Name:BETTY JO SCHOPE D.D.S., P.C.
Entity Type:Organization
Organization Name:BETTY JO SCHOPE D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SCHOPE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-260-8089
Mailing Address - Street 1:3464 BRIARGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4168
Mailing Address - Country:US
Mailing Address - Phone:719-260-8089
Mailing Address - Fax:719-265-6201
Practice Address - Street 1:3464 BRIARGATE BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4168
Practice Address - Country:US
Practice Address - Phone:719-260-8089
Practice Address - Fax:719-265-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7293261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental