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General NPI Number Information
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NPI Number | 1447047212
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Entity Type | Individual
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Provider Name | LAUREN ASHLEY HOPPER
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Gender | Female
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 2154 GOODMAN RD W # 1
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City | HORN LAKE
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State | MS
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Zip | 38637-1303
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Country | US
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Telephone | 662-393-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 2031 BLUE RIBBON CIR
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City | BENTON
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State | AR
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Zip | 72019-6764
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Country | US
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Telephone | 501-317-8445
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 111205
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License Number State | MS
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