Koppenhaver, Jeremy J

Koppenhaver, Jeremy J is an individual health care provider with primary practice located at 351 W 6Th Street Bldg 440, Fort Stewart GA 31314. He recently has 2 registered licenses in different health care specialties including Dental Providers / Prosthodontics, Dental Providers / Dentist. Dental Providers / Prosthodontics is his primary health care specialty. Koppenhaver, Jeremy J can be contacted via phone (912) 435-7006.

Contact Information

Primary practice address
351 W 6Th Street Bldg 440 Fort Stewart GA 31314
Phone: (912) 435-7006
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Prosthodontics 1223P0700X DS038003 Pennsylvania
Dental Providers / Dentist 122300000X DS38003 Pennsylvania

Profile Details

NPI number 1043441108
LBN Legal business name Koppenhaver, Jeremy J
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2009
Last updated Oct 19th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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