Provider Demographics
NPI:1154916153
Name:ANSON L HOOPER DDS PLLC
Entity type:Organization
Organization Name:ANSON L HOOPER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ANSON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:928-778-2421
Mailing Address - Street 1:802 SCHEMMER DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-2347
Mailing Address - Country:US
Mailing Address - Phone:928-778-2421
Mailing Address - Fax:928-443-5187
Practice Address - Street 1:802 SCHEMMER DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-2347
Practice Address - Country:US
Practice Address - Phone:928-778-2421
Practice Address - Fax:928-443-5187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental