Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 10574 | MD |
Y | 1223P0700X | Prosthodontist | DN12464 | FL |
NPI | 1164540407 |
---|---|
Provider Name | Dr. David Skopp |
First Address | Palm Beach Gardens, FL 33410-3335 |
Second Address | Palm Beach Gardens, FL 33410-3335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 30/05/2015 |