Provider Demographics
NPI:1629169271
Name:POPKY, ERIC BRIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRIAN
Last Name:POPKY
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 1:40 BRANFORD LN
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2252
Mailing Address - Country:US
Mailing Address - Phone:843-682-3206
Mailing Address - Fax:
Practice Address - Street 1:40 BRANFORD LN
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2252
Practice Address - Country:US
Practice Address - Phone:843-682-3206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC46591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice