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General NPI Number Information
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NPI Number | 1053472100
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Entity Type | Individual
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Provider Name | JOHN CARTER HOPPIN DDS
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 WESTBURY DR STE 300 BLDG C
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City | ST CHARLES
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State | MO
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Zip | 63301-2541
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Country | US
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Telephone | 636-946-9890
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Fax | 636-946-7195
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Provider Business Mailing Address
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Address Line | 14301 CONWAY RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017
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Country | US
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Telephone | 314-469-3320
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Fax | 314-469-3373
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 11530
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License Number State | MO
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