MEDICARE: RPB PEDIATRIC DENTISTRY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881382802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RPB PEDIATRIC DENTISTRY PA

Provider Business Mailing Address
First Line	:	1019 N STATE ROAD 7 STE A
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-5100
Country	:	US
Telephone Number	:	561-337-9333
Fax Number	:

Provider Business Practice Location Address
First Line	:	1019 N STATE ROAD 7 STE A
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-5100
Country	:	US
Telephone Number	:	561-337-9333
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DREW POPPER
Credential	:	DMD
Telephone Number	:	203-415-6875

Provider Enumeration Date	:	04/27/2023
Last Update Date	:	04/27/2023

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