Provider Demographics
NPI:1407295389
Name:POPELARS, MICHAEL CHISTOPHER (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHISTOPHER
Last Name:POPELARS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-1602
Mailing Address - Country:US
Mailing Address - Phone:920-849-9667
Mailing Address - Fax:
Practice Address - Street 1:1110 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:CHILTON
Practice Address - State:WI
Practice Address - Zip Code:53014-1602
Practice Address - Country:US
Practice Address - Phone:920-849-9667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7094-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice