Provider Demographics
NPI:1477039428
Name:POPE, LEAH (RDH)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CASH RD NW
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-3833
Mailing Address - Country:US
Mailing Address - Phone:870-836-5003
Mailing Address - Fax:870-836-3163
Practice Address - Street 1:135 CASH RD NW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-3833
Practice Address - Country:US
Practice Address - Phone:870-836-5003
Practice Address - Fax:870-836-3163
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1388124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist