Provider Demographics
NPI:1427169119
Name:HOOTON, PHILIP L (DMD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:L
Last Name:HOOTON
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 1:206 ARNOW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-4071
Mailing Address - Country:US
Mailing Address - Phone:912-882-2005
Mailing Address - Fax:912-882-2342
Practice Address - Street 1:206 ARNOW DR
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4071
Practice Address - Country:US
Practice Address - Phone:912-882-2005
Practice Address - Fax:912-882-2342
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist