Provider Demographics
NPI:1013423581
Name:YVONNE B KINKOPF DDS INC
Entity Type:Organization
Organization Name:YVONNE B KINKOPF DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:BILO
Authorized Official - Last Name:KINKOPF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-673-6830
Mailing Address - Street 1:3102 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-3643
Mailing Address - Country:US
Mailing Address - Phone:330-673-6830
Mailing Address - Fax:
Practice Address - Street 1:3102 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-3643
Practice Address - Country:US
Practice Address - Phone:330-673-6830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental