Provider Demographics
NPI:1194166785
Name:POP, ADRIAN IOAN (DDS)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:IOAN
Last Name:POP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 E GOLF RD
Mailing Address - Street 2:APT #6
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-5285
Mailing Address - Country:US
Mailing Address - Phone:224-595-7179
Mailing Address - Fax:
Practice Address - Street 1:1520 CARLEMONT DR
Practice Address - Street 2:SUITE E
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1834
Practice Address - Country:US
Practice Address - Phone:815-444-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029468122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist