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Contact Information

JEREMY J KOPPENHAVER, DMD
351 W 6TH STREET
BLDG 440
FORT STEWART, GA31314
 Phone: 912-435-7006
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthodontics

1223P0700X
 

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JEREMY J KOPPENHAVER · (Male)

NPI Number 1043441108
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 08/06/2009
Last updated 10/19/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • PA License # DS038003
  • PA License # DS38003
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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