Provider Demographics
NPI:1346691433
Name:POPP, LEAH LADELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:LADELLE
Last Name:POPP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LEAH
Other - Middle Name:LADELLE
Other - Last Name:SCRUGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-1336
Practice Address - Country:US
Practice Address - Phone:570-271-6355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist