Provider Demographics
NPI:1316041346
Name:POPKIN, LAWRENCE ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:ALAN
Last Name:POPKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 GLEN COVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1007
Mailing Address - Country:US
Mailing Address - Phone:516-621-2225
Mailing Address - Fax:516-621-7596
Practice Address - Street 1:73 GLEN COVE RD
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1007
Practice Address - Country:US
Practice Address - Phone:516-621-2225
Practice Address - Fax:516-621-7596
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0319411223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics