Provider Demographics
NPI:1083453195
Name:POPPE, LAUREN (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:POPPE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:LOCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9247 E PALMETTO AVE
Mailing Address - Street 2:
Mailing Address - City:SOLON SPRINGS
Mailing Address - State:WI
Mailing Address - Zip Code:54873-8041
Mailing Address - Country:US
Mailing Address - Phone:608-509-8101
Mailing Address - Fax:
Practice Address - Street 1:6881 S LAKE AVE
Practice Address - Street 2:
Practice Address - City:LAKE NEBAGAMON
Practice Address - State:WI
Practice Address - Zip Code:54849-9264
Practice Address - Country:US
Practice Address - Phone:715-374-2856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001487-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice