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General NPI Number Information
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NPI Number | 1083491310
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Entity Type | Organization
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Legal Business Name | S POPE DDS & R HURWICH DDS P.C.
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 332 SKOKIE VALLEY RD STE 222
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-4460
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Country | US
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Telephone | 219-718-0615
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Fax |
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Provider Business Mailing Address
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Address Line | 332 SKOKIE VALLEY RD STE 222
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-4460
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Country | US
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Telephone | 219-718-0615
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RISA ARIELLE HURWICH
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Credential | DDS, MPH
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Telephone | 219-718-0615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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