Avanthi Kopuri, DMD, MSD, Mha, PLLC

Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Rockledge, FL

NPI 1861896474 · NPPES record last updated Aug 28, 2020

Key facts

NPI
1861896474
Entity type
Organization (NPI type 2)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
P00000094134 (FL)
Legal business name
AVANTHI KOPURI, DMD, MSD, MHA, PLLC
Practice address
3010 S Fiske Blvd
Rockledge, FL 32955-4302
Phone
(321) 638-4455
Fax
(321) 638-1203
NPI assigned
Oct 13, 2014
Organization subpart
No

Authorized official

Name
Dr. Avanthi Kopuri, DMD, MSD, MHA
Title
President
Phone
(305) 788-4415

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Avanthi Kopuri DMD MSD Mha PLLC (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223X0400X P00000094134 FL Yes

Addresses

Primary practice location

3010 S Fiske Blvd
Rockledge, FL 32955-4302

Mailing address

3010 S Fiske Blvd
Rockledge, FL 32955-4302
Phone (321) 638-4455

Other names

  • Central Florida Orthodontic Specialists Doing business as

Other providers in Rockledge, FL

All providers in Rockledge, FL · Orthodontics and Dentofacial Orthopedics Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.