Provider Demographics
NPI:1366557837
Name:POPE, JOAN E (DDS)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:E
Last Name:POPE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1999 4TH ST N
Mailing Address - Street 2:SUITE B
Mailing Address - City:WAHPETON
Mailing Address - State:ND
Mailing Address - Zip Code:58075-3422
Mailing Address - Country:US
Mailing Address - Phone:701-642-2656
Mailing Address - Fax:701-642-2657
Practice Address - Street 1:1999 4TH ST N
Practice Address - Street 2:SUITE B
Practice Address - City:WAHPETON
Practice Address - State:ND
Practice Address - Zip Code:58075-3422
Practice Address - Country:US
Practice Address - Phone:701-642-2656
Practice Address - Fax:701-642-2657
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND16641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice