Healthcare Provider Details

I. General information

NPI: 1417967639
Provider Name (Legal Business Name): JAMES FRANCIS HOAG DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 S DAVID ST
CASPER WY
82601-3736
US

IV. Provider business mailing address

814 S DAVID ST
CASPER WY
82601-3736
US

V. Phone/Fax

Practice location:
  • Phone: 307-265-6565
  • Fax:
Mailing address:
  • Phone: 307-265-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number624
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: