Provider Demographics
NPI:1154676732
Name:DEHOOGH, BRETT C (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:C
Last Name:DEHOOGH
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 1:9478 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-6328
Mailing Address - Country:US
Mailing Address - Phone:515-556-6367
Mailing Address - Fax:
Practice Address - Street 1:1025 60TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5811
Practice Address - Country:US
Practice Address - Phone:515-222-1244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist