Provider Demographics
NPI:1982892030
Name:KOPTI, ELIAS GABI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:GABI
Last Name:KOPTI
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 1:855 VILLAGE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OAKS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-3016
Mailing Address - Country:US
Mailing Address - Phone:651-447-5999
Mailing Address - Fax:
Practice Address - Street 1:855 VILLAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:NORTH OAKS
Practice Address - State:MN
Practice Address - Zip Code:55127-3016
Practice Address - Country:US
Practice Address - Phone:651-447-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND108421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice