Provider Demographics
NPI:1801966320
Name:COPELAND, WILLIAM MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:COPELAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:W
Other - Middle Name:MICHAEL
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2397 C NW MILITARY HWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231
Mailing Address - Country:US
Mailing Address - Phone:210-342-0766
Mailing Address - Fax:210-349-4891
Practice Address - Street 1:2397 C NW MILITARY HWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231
Practice Address - Country:US
Practice Address - Phone:210-341-3222
Practice Address - Fax:210-349-4891
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX128131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice