Provider Demographics
NPI:1730271743
Name:KOPLON, SCOTT A (DMD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:KOPLON
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 1:8125 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:AL
Mailing Address - Zip Code:35094-2227
Mailing Address - Country:US
Mailing Address - Phone:205-699-2551
Mailing Address - Fax:205-699-5653
Practice Address - Street 1:8125 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-2227
Practice Address - Country:US
Practice Address - Phone:205-699-2551
Practice Address - Fax:205-699-5653
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL42351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice