Provider Demographics
NPI:1215009816
Name:COPPLE, WILLIAM B (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:COPPLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E LOCKLING ST
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:64628-2336
Mailing Address - Country:US
Mailing Address - Phone:660-258-3553
Mailing Address - Fax:660-258-5743
Practice Address - Street 1:125 E LOCKLING ST
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:MO
Practice Address - Zip Code:64628-2336
Practice Address - Country:US
Practice Address - Phone:660-258-3553
Practice Address - Fax:660-258-5743
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0120711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice