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General NPI Number Information
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NPI Number | 1134610926
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Entity Type | Individual
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Provider Name | REID WESTON POPPLE DMD
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Gender | Male
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 2992 STONE MOUNTAIN HWY A100
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City | SNELLVILLE
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State | GA
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Zip | 30078
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Country | US
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Telephone | 770-972-1039
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Fax |
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Provider Business Mailing Address
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Address Line | 773 VEDADO WAY NE
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City | ATLANTA
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State | GA
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Zip | 30308-1723
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Country | US
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Telephone | 770-241-9448
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN015631
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License Number State | GA
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