Provider Demographics
NPI:1558480475
Name:COPELAND, JAMES BRENT (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRENT
Last Name:COPELAND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 N FANT ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4826
Mailing Address - Country:US
Mailing Address - Phone:864-226-6574
Mailing Address - Fax:864-225-0588
Practice Address - Street 1:1406 N FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4826
Practice Address - Country:US
Practice Address - Phone:864-226-6574
Practice Address - Fax:864-225-0588
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice