MEDICARE: DR. PAUL DUANE HOPKINS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	144563	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	591998	OTHER		UNITED CONCORDIA

General Provider Information

NPI Number	:	1295844991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL DUANE HOPKINS DDS

Provider Business Mailing Address
First Line	:	5275 ADAMS AVE PKWY STE A
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84405-7238
Country	:	US
Telephone Number	:	801-479-1181
Fax Number	:	801-479-1182

Provider Business Practice Location Address
First Line	:	5275 ADAMS AVE PKWY STE A
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84405-7238
Country	:	US
Telephone Number	:	801-479-1181
Fax Number	:	801-479-1182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	09/15/2022

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