Provider Demographics
NPI:1215009543
Name:KOPKO, ELENA ALONA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:ALONA
Last Name:KOPKO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 PLANTATION RD
Mailing Address - Street 2:SUITE #9
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4206
Mailing Address - Country:US
Mailing Address - Phone:850-477-2355
Mailing Address - Fax:850-477-2209
Practice Address - Street 1:7100 PLANTATION RD
Practice Address - Street 2:SUITE #9
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-4206
Practice Address - Country:US
Practice Address - Phone:850-477-2355
Practice Address - Fax:850-477-2209
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN169791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice