Healthcare Provider Details

I. General information

NPI: 1598042814
Provider Name (Legal Business Name): JAMES F HOAG DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 11/23/2011
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: 307-265-5999
Mailing address:
  • Phone: 307-265-6565
  • Fax: 307-265-5999

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: DR. JAMES F HOAG
Title or Position: DR.
Credential: DDS MS
Phone: 307-265-6565