Provider Demographics
NPI:1740715580
Name:DR. ANDREW T. POPESCU DMD, PLLC
Entity type:Organization
Organization Name:DR. ANDREW T. POPESCU DMD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:TUDOR
Authorized Official - Last Name:POPESCU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-212-8194
Mailing Address - Street 1:5205 S DURANGO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0195
Mailing Address - Country:US
Mailing Address - Phone:702-384-2828
Mailing Address - Fax:
Practice Address - Street 1:5205 S DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0195
Practice Address - Country:US
Practice Address - Phone:702-384-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV67681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty