Provider Demographics
NPI:1124360557
Name:MICHAEL R. CLOPP D.M.D.
Entity Type:Organization
Organization Name:MICHAEL R. CLOPP D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:CLOPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-776-4088
Mailing Address - Street 1:20399 ROUTE 19
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066
Mailing Address - Country:US
Mailing Address - Phone:724-776-4088
Mailing Address - Fax:724-776-3955
Practice Address - Street 1:20399 ROUTE 19
Practice Address - Street 2:SUITE 110
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066
Practice Address - Country:US
Practice Address - Phone:724-776-4088
Practice Address - Fax:724-776-3955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-24
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029785-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty