Provider Demographics
NPI:1942943352
Name:PROCOPIO, CHRISTOPHER SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:PROCOPIO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:CHRISTOPER
Other - Middle Name:SCOTT
Other - Last Name:LUMPKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7844 N APACHE LN
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-4560
Mailing Address - Country:US
Mailing Address - Phone:801-319-3277
Mailing Address - Fax:
Practice Address - Street 1:7844 N APACHE LN
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005-4560
Practice Address - Country:US
Practice Address - Phone:801-319-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT127975121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice