Provider Demographics
NPI:1932688082
Name:KOPA, MARKUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARKUS
Middle Name:
Last Name:KOPA
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 1:14041 GRANT RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-0041
Mailing Address - Country:US
Mailing Address - Phone:281-876-0131
Mailing Address - Fax:
Practice Address - Street 1:14041 GRANT RD STE 110
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-0041
Practice Address - Country:US
Practice Address - Phone:281-876-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX388461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty