Healthcare Provider Details

I. General information

NPI: 1558574533
Provider Name (Legal Business Name): CHARLES R HOOK D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COLLEGE OF DENTAL MEDICINE, MUSC BSB 341 173 ASHLEY AVENUE
CHARLESTON SC
29425
US

IV. Provider business mailing address

750 DRAGOON DR
MT PLEASANT SC
29464-3023
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-3811
  • Fax:
Mailing address:
  • Phone: 843-881-1471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberSC1748
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: