Provider Demographics
NPI:1003975780
Name:HOPKIN, JESS CLINTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESS
Middle Name:CLINTON
Last Name:HOPKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:209 S. STATE SUITE 'A'
Mailing Address - City:MORGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84050-0021
Mailing Address - Country:US
Mailing Address - Phone:801-845-9090
Mailing Address - Fax:801-845-9109
Practice Address - Street 1:209 SOUTH STATE ST SUITE 'A'
Practice Address - Street 2:
Practice Address - City:MORGAN
Practice Address - State:UT
Practice Address - Zip Code:84050
Practice Address - Country:US
Practice Address - Phone:801-845-9090
Practice Address - Fax:801-845-9109
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT344398-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice