Provider Demographics
NPI:1083491310
Name:S POPE DDS & R HURWICH DDS P.C.
Entity Type:Organization
Organization Name:S POPE DDS & R HURWICH DDS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RISA
Authorized Official - Middle Name:ARIELLE
Authorized Official - Last Name:HURWICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MPH
Authorized Official - Phone:219-718-0615
Mailing Address - Street 1:332 SKOKIE VALLEY RD STE 222
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-4460
Mailing Address - Country:US
Mailing Address - Phone:219-718-0615
Mailing Address - Fax:
Practice Address - Street 1:332 SKOKIE VALLEY RD STE 222
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-4460
Practice Address - Country:US
Practice Address - Phone:219-718-0615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty