Individual
DR. HARRY EDWARD BOPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1111 N PARKWAY FRONTAGE RD, LAKELAND, FL 33803-0400
(863) 644-2408
(863) 646-8493
Mailing address
1111 N PARKWAY FRONTAGE RD, LAKELAND, FL 33803-0400
(863) 644-2408
(863) 646-8493
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D5979
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0743097-00
—
FL
01
—
250953
BC/BS OF VIRGINIA
VA
01
—
3026867
BLUE CROSS BLUE SHIELD TN
TN
01
—
600354
DELTA DENTAL
FL
01
—
60708
UNITED CONCORDIA PROVIDER
FL
01
—
70108
ATLANTIC DENTAL PROV #
FL
01
—
85704
BCBS OF FLORIDA PROVIDER
FL
Enumeration date
07/22/2006
Last updated
10/25/2010
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