Provider Demographics
NPI:1144323734
Name:POPE W ODEN III DDS APDC
Entity type:Organization
Organization Name:POPE W ODEN III DDS APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:POPE
Authorized Official - Middle Name:WEBB
Authorized Official - Last Name:ODEN
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:318-747-7978
Mailing Address - Street 1:2285 BENTON ROAD
Mailing Address - Street 2:D103
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111
Mailing Address - Country:US
Mailing Address - Phone:318-747-7978
Mailing Address - Fax:318-747-0001
Practice Address - Street 1:2285 BENTON ROAD
Practice Address - Street 2:D103
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111
Practice Address - Country:US
Practice Address - Phone:318-747-7978
Practice Address - Fax:318-747-7978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4211122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty