Provider Demographics
NPI:1164792859
Name:KNOPF AND MCDONALD DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:KNOPF AND MCDONALD DENTAL PARTNERSHIP
Other - Org Name:MILLHOPPER FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOPF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-377-1705
Mailing Address - Street 1:3510 NW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6104
Mailing Address - Country:US
Mailing Address - Phone:352-377-1705
Mailing Address - Fax:352-377-1093
Practice Address - Street 1:3510 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6104
Practice Address - Country:US
Practice Address - Phone:352-377-1705
Practice Address - Fax:352-377-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN88051223G0001X
FLDN171101223G0001X
FLDN188671223G0001X
FLDN197411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty