Provider Demographics
NPI:1497894901
Name:MICHAEL C. POPE, D.M.D. AND LINDSAY B. POPE, D.M.D., PC
Entity Type:Organization
Organization Name:MICHAEL C. POPE, D.M.D. AND LINDSAY B. POPE, D.M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-487-5540
Mailing Address - Street 1:8 EASTBROOK BND
Mailing Address - Street 2:SUITE A
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1530
Mailing Address - Country:US
Mailing Address - Phone:770-487-5540
Mailing Address - Fax:770-487-4531
Practice Address - Street 1:8 EASTBROOK BND
Practice Address - Street 2:SUITE A
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1530
Practice Address - Country:US
Practice Address - Phone:770-487-5540
Practice Address - Fax:770-487-4531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0122031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID