Provider Demographics
NPI:1396101101
Name:JONATHAN E. POPE, D.M.D., PC
Entity type:Organization
Organization Name:JONATHAN E. POPE, D.M.D., PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-536-0418
Mailing Address - Street 1:184 OLD HIGHWAY 431
Mailing Address - Street 2:SUITE D
Mailing Address - City:HAMPTON COVE
Mailing Address - State:AL
Mailing Address - Zip Code:35763-9281
Mailing Address - Country:US
Mailing Address - Phone:256-536-0418
Mailing Address - Fax:256-536-1527
Practice Address - Street 1:184 OLD HIGHWAY 431
Practice Address - Street 2:SUITE D
Practice Address - City:HAMPTON COVE
Practice Address - State:AL
Practice Address - Zip Code:35763-9281
Practice Address - Country:US
Practice Address - Phone:256-536-0418
Practice Address - Fax:256-536-1527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty