Provider Demographics
NPI:1609942010
Name:LOOPER, JOSEPH GRIFFIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GRIFFIN
Last Name:LOOPER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 BRIARCLIFF RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-2142
Mailing Address - Country:US
Mailing Address - Phone:404-872-3838
Mailing Address - Fax:404-872-9491
Practice Address - Street 1:1799 BRIARCLIFF RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-2142
Practice Address - Country:US
Practice Address - Phone:404-872-3838
Practice Address - Fax:404-872-9491
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA100441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice