Provider Demographics
NPI:1689805475
Name:POPOVICIU, CHRISTINA ELIZABETH (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:POPOVICIU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 S STATE ROAD 135
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-6480
Mailing Address - Country:US
Mailing Address - Phone:317-882-8000
Mailing Address - Fax:317-888-1774
Practice Address - Street 1:1711 S STATE ROAD 135
Practice Address - Street 2:SUITE B
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-6480
Practice Address - Country:US
Practice Address - Phone:317-882-8000
Practice Address - Fax:317-888-1774
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011177A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice