Provider Demographics
NPI:1396417044
Name:POPOV, HRISTINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:HRISTINA
Middle Name:
Last Name:POPOV
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 HAMLET AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-4423
Mailing Address - Country:US
Mailing Address - Phone:401-769-0047
Mailing Address - Fax:401-769-2555
Practice Address - Street 1:52 HAMLET AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4423
Practice Address - Country:US
Practice Address - Phone:401-769-0047
Practice Address - Fax:401-769-2555
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN03583122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist