Provider Demographics
NPI:1285061903
Name:HOOGAR, MAMATA (DMD)
Entity type:Individual
Prefix:MRS
First Name:MAMATA
Middle Name:
Last Name:HOOGAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 STANWOOD DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4785
Mailing Address - Country:US
Mailing Address - Phone:954-655-0605
Mailing Address - Fax:
Practice Address - Street 1:10868 US HIGHWAY 15 501
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5149
Practice Address - Country:US
Practice Address - Phone:910-992-3089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice