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NPI Code Detail

MEDICARE: DR. JAMES CHARLES HOOTS DDS

MEDICARE: DR. JAMES CHARLES HOOTS 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
11223G0001XGeneral Practice Dentistry5001101-015WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720008014
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES CHARLES HOOTS DDS
Provider Business Mailing Address
First Line : N36W7575 BUCHANAN CT
Second Line :
City : CEDARBURG
State : WI
Zip : 53012-2275
Country : US
Telephone Number : 262-377-4695
Fax Number :
Provider Business Practice Location Address
First Line : 545 E JOHNSON ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-2856
Country : US
Telephone Number : 920-924-9090
Fax Number : 920-921-0800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 07/09/2007

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Directions to “ DR. JAMES CHARLES HOOTS DDS” Practice Location

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