Provider Demographics
NPI:1215151501
Name:HOOPER, ROBERT W (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:HOOPER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 HIGHWAY 98 E
Mailing Address - Street 2:
Mailing Address - City:DANIELSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30633-5834
Mailing Address - Country:US
Mailing Address - Phone:706-795-2145
Mailing Address - Fax:706-795-3999
Practice Address - Street 1:371 HIGHWAY 98 E
Practice Address - Street 2:
Practice Address - City:DANIELSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30633-5834
Practice Address - Country:US
Practice Address - Phone:706-795-2145
Practice Address - Fax:706-795-3999
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0114161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice