Provider Demographics
NPI:1649396912
Name:KOPSKY, CHRISTINE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:KOPSKY
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 1:25609 N DANNY LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RIO VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85263-8131
Mailing Address - Country:US
Mailing Address - Phone:480-471-7235
Mailing Address - Fax:480-471-2301
Practice Address - Street 1:25609 N DANNY LN
Practice Address - Street 2:SUITE 2
Practice Address - City:RIO VERDE
Practice Address - State:AZ
Practice Address - Zip Code:85263-8131
Practice Address - Country:US
Practice Address - Phone:480-471-7235
Practice Address - Fax:480-471-2301
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice