MEDICARE: JAMES F HOAG DDS PC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	624	WY

General Provider Information

NPI Number	:	1598042814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES F HOAG DDS PC

Provider Business Mailing Address
First Line	:	814 S DAVID ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-3736
Country	:	US
Telephone Number	:	307-265-6565
Fax Number	:	307-265-5999

Provider Business Practice Location Address
First Line	:	814 S DAVID ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-3736
Country	:	US
Telephone Number	:	307-265-6565
Fax Number	:	307-265-5999

Authorized Official
Title or Position	:	DR.
Name	:	DR. JAMES F HOAG
Credential	:	DDS MS
Telephone Number	:	307-265-6565

Provider Enumeration Date	:	11/15/2011
Last Update Date	:	11/23/2011

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