Provider Demographics
NPI:1679804157
Name:JOHN C HOPPIN, DDS., PC
Entity type:Organization
Organization Name:JOHN C HOPPIN, DDS., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-946-9890
Mailing Address - Street 1:1 WESTBURY DRIVE SUITE 300
Mailing Address - Street 2:
Mailing Address - City:ST. CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301
Mailing Address - Country:US
Mailing Address - Phone:636-946-9890
Mailing Address - Fax:636-946-9890
Practice Address - Street 1:1 WESTBURY DR STE 300
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2560
Practice Address - Country:US
Practice Address - Phone:636-946-9890
Practice Address - Fax:636-946-7195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0115301223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty