Michael Scott Kopecky
Prosthodontist
145 N 18th Avenue
West Bend
, Wisconsin 53095
Michael Scott Kopecky
Prosthodontist
145 N 18th Avenue
West Bend
, Wisconsin 53095
(262) 334-3552
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About
Features
Specialties
- Prosthodontist
Languages spoken
- English
Location
First Address
- Michael Scott Kopecky
- 145 N 18th Avenue
- West Bend, WI
- Zip : 53095
- Fax : (262) 334-3552
- Phone : (262) 334-3084
Second Address
- Michael Scott Kopecky
- 145 N 18th Avenue
- West Bend, WI
- Zip : 53095
- Fax : (262) 334-3552
- Phone : (262) 334-3084
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0700X | Prosthodontist | 4408 | WI |
National Provider Identifier
| NPI | 1023173069 |
|---|---|
| Provider Name | Michael Scott Kopecky |
| First Address | West Bend, WI 53095 |
| Second Address | West Bend, WI 53095 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/12/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 33761800 | (05) | WI |
| 650286 | UNITED CONCORDIA (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.