=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952803207
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHARLES R HOSKINS DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2018
-----------------------------------------------------
Last Update Date | 06/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2301 MOODY PARKWAY SUITE 9
-----------------------------------------------------
City | MOODY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-640-0145
-----------------------------------------------------
Fax | 205-640-6002
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2301 MOODY PARKWAY SUITE 9
-----------------------------------------------------
City | MOODY
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-640-0145
-----------------------------------------------------
Fax | 205-640-6002
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | PA.0006499.P
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------