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General NPI Number Information
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NPI Number | 1700286291
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Entity Type | Organization
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Legal Business Name | HOPKINS FAMILY DENTISTRY LLC
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 06/01/2023
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Provider Practice Location Address
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Address Line | 300 MAIN ST SUITE 101
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City | ST SIMONS ISLAND
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State | GA
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Zip | 31522-1666
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Country | US
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Telephone | 912-638-9001
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Fax |
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Provider Business Mailing Address
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Address Line | 300 MAIN ST SUITE 101
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City | ST SIMONS ISLAND
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State | GA
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Zip | 31522-1666
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Country | US
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Telephone | 912-638-9001
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CHARLES THOMAS HOPKINS III
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Credential | D.M.D.
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Telephone | 770-468-4685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN014669
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License Number State | GA
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