# POPOVICH DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750660221
- **Authorized official:** DR. JAMES GABRIEL POPOVICH D.D.S. (CEO)
- **Authorized official phone:** (219) 663-0252

## Contact information

- **Practice address:** 223 S COURT ST, CROWN POINT, IN 46307-3951
- **Practice address phone:** (219) 663-0252
- **Practice address fax:** (219) 663-3249
- **Mailing address:** 223 S COURT ST, CROWN POINT, IN 46307-3951
- **Mailing address phone:** (219) 663-0252
- **Mailing address fax:** (219) 663-3249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12006634 | IN | — |
| 122300000X | Dentist | 12010460A | IN | Yes |

## Other

- **Enumeration date:** 08/15/2011
- **Last updated:** 08/15/2011