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General NPI Number Information
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NPI Number | 1679866032
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Entity Type | Individual
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Provider Name | SAIDAT BAMIDELE POPOOLA RDH, B.S.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 200 GIRARD ST
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City | GAITHERSBURG
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State | MD
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Zip | 20877-3466
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Country | US
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Telephone | 240-720-0439
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Fax |
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Provider Business Mailing Address
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Address Line | 10570 FAULKNER RIDGE CIR
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City | COLUMBIA
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State | MD
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Zip | 21044-2230
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Country | US
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Telephone | 443-547-0419
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 6194
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License Number State | MD
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