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General NPI Number Information
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NPI Number | 1679804157
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Entity Type | Organization
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Legal Business Name | JOHN C HOPPIN, DDS., PC
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 1 WESTBURY DR STE 300
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2560
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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 | 1 WESTBURY DRIVE SUITE 300
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City | ST. CHARLES
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State | MO
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Zip | 63301
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Country | US
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Telephone | 636-946-9890
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Fax | 636-946-9890
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Authorized Official
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Title or Position | PERIODONTIST
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Name | DR. JOHN C HOPPIN
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Credential | DDS
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Telephone | 636-946-9890
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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 | 011530
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License Number State | MO
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