MEDICARE: DR. GREGORY B HOPKINSON D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12012500A	IN
2	122300000X	Dentist	12012500A	IN

General Provider Information

NPI Number	:	1063891026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY B HOPKINSON D.D.S.

Provider Business Mailing Address
First Line	:	14139 TOWN CENTER BLVD STE 200
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-3368
Country	:	US
Telephone Number	:	317-773-9992
Fax Number	:

Provider Business Practice Location Address
First Line	:	14139 TOWN CENTER BLVD STE 200
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-3368
Country	:	US
Telephone Number	:	317-773-9992
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2015
Last Update Date	:	12/06/2018

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