Provider Demographics
NPI:1184612285
Name:KOPLOW, STEVE ALLEN
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:ALLEN
Last Name:KOPLOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 FOX MEADOWS BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-6937
Mailing Address - Country:US
Mailing Address - Phone:865-774-1442
Mailing Address - Fax:865-774-2938
Practice Address - Street 1:1011 MIDDLE CREEK RD
Practice Address - Street 2:SUITE #2
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-2940
Practice Address - Country:US
Practice Address - Phone:865-774-1442
Practice Address - Fax:865-774-2938
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN81711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice