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General NPI Number Information
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NPI Number | 1962506659
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Entity Type | Individual
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Provider Name | LAQUANIS SHENA HOOKER DDS
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Gender | Female
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 2467 GOLDEN CAMP RD
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City | AUGUSTA
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State | GA
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Zip | 30906-5515
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Country | US
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Telephone | 706-790-4440
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Fax |
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Provider Business Mailing Address
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Address Line | 2467 GOLDEN CAMP RD
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City | AUGUSTA
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State | GA
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Zip | 30906-5515
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Country | US
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Telephone | 706-790-4440
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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 | 4240
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN014862
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License Number State | GA
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