Provider Demographics
NPI:1194838557
Name:KOPLAN, ALLAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
Last Name:KOPLAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3332 OLD MONTGOMERY HWY
Mailing Address - Street 2:STE 111
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4249
Mailing Address - Country:US
Mailing Address - Phone:205-871-5100
Mailing Address - Fax:205-871-5101
Practice Address - Street 1:3332 OLD MONTGOMERY HWY
Practice Address - Street 2:STE 111
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4249
Practice Address - Country:US
Practice Address - Phone:205-871-5100
Practice Address - Fax:205-871-5101
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3000204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T68745Medicare UPIN