Healthcare Provider Details

I. General information

NPI: 1295570992
Provider Name (Legal Business Name): DENNIS HOAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 WAKEFIELD DR
LOCUST GROVE VA
22508-5135
US

IV. Provider business mailing address

305 WAKEFIELD DR
LOCUST GROVE VA
22508-5135
US

V. Phone/Fax

Practice location:
  • Phone: 301-377-9120
  • Fax:
Mailing address:
  • Phone: 301-253-1242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: