Healthcare Provider Details

I. General information

NPI: 1396101101
Provider Name (Legal Business Name): JONATHAN E. POPE, D.M.D., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 OLD HIGHWAY 431 SUITE D
HAMPTON COVE AL
35763-9281
US

IV. Provider business mailing address

184 OLD HIGHWAY 431 SUITE D
HAMPTON COVE AL
35763-9281
US

V. Phone/Fax

Practice location:
  • Phone: 256-536-0418
  • Fax: 256-536-1527
Mailing address:
  • Phone: 256-536-0418
  • Fax: 256-536-1527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number5310
License Number StateAL

VIII. Authorized Official

Name: DR. JONATHAN EDWARD POPE
Title or Position: OWNER/DENTIST
Credential: D.M.D.
Phone: 256-536-0418