Provider Demographics
NPI:1962552927
Name:HOPPER, BARRY L (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:HOPPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SPANISH OAK RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-2722
Mailing Address - Country:US
Mailing Address - Phone:423-968-7224
Mailing Address - Fax:
Practice Address - Street 1:975 EMERGENCY RD.
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-0630
Practice Address - Country:US
Practice Address - Phone:423-323-2796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21771223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health