Healthcare Provider Details

I. General information

NPI: 1073595302
Provider Name (Legal Business Name): WILLIAM LEE HOOK JR. D.M.D., M.S.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 NEWPORT PIKE SUITE 304
GAP PA
17527-9579
US

IV. Provider business mailing address

91 NEWPORT PIKE SUITE 304
GAP PA
17527-9579
US

V. Phone/Fax

Practice location:
  • Phone: 717-442-3639
  • Fax: 171-442-4281
Mailing address:
  • Phone: 717-442-3639
  • Fax: 171-442-4281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS018645L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: