Provider Demographics
NPI:1245676170
Name:POPPLE, BEN S (DMD)
Entity type:Individual
Prefix:DR
First Name:BEN
Middle Name:S
Last Name:POPPLE
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:1635 HIGHWAY 34 E STE D
Mailing Address - Street 2:WHITE OAK PEDIATRIC DENTISTRY
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2173
Mailing Address - Country:US
Mailing Address - Phone:470-210-8050
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST # T-209
Practice Address - Street 2:YALE-NEW HAVEN HOSPITAL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2464
Practice Address - Fax:203-688-1426
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-19
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADN0148891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry