Provider Demographics
NPI:1932517042
Name:KOPYNETS, VIKTOR V (DMD)
Entity Type:Individual
Prefix:
First Name:VIKTOR
Middle Name:V
Last Name:KOPYNETS
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 1:5201 NW 2ND AVE
Mailing Address - Street 2:APT 211
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3837
Mailing Address - Country:US
Mailing Address - Phone:347-740-1230
Mailing Address - Fax:
Practice Address - Street 1:5201 NW 2ND AVE
Practice Address - Street 2:APT 211
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-3837
Practice Address - Country:US
Practice Address - Phone:347-740-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-01
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20696122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist