Provider Demographics
NPI:1174901367
Name:KOPASZ, CHRISTY L (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:L
Last Name:KOPASZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:81423-0280
Mailing Address - Country:US
Mailing Address - Phone:970-327-4233
Mailing Address - Fax:970-327-4228
Practice Address - Street 1:1350 S. ASPEN STREET
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:CO
Practice Address - Zip Code:81423
Practice Address - Country:US
Practice Address - Phone:970-327-4233
Practice Address - Fax:970-327-4228
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00202829122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program