IVAN KOUTSOPATRIY, DDS

Prosthodontics · FORT BRAGG, NC

Individual Active NPI 1497378053

Taxonomy & licensure

Specialty	Code	Primary	License	State
Prosthodontics	1223P0700X	✓	30.026114	OH
General Practice Dentistry	1223G0001X		30.026114	OH
Student in an Organized Health Care Education/Training Program	390200000X		30.026114	OH
Dentist	122300000X		30.026114	OH

Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.