Provider Demographics
NPI:1164822896
Name:HOOVER, JOHN EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWARD
Last Name:HOOVER
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 1:405 INWOOD RD
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-4825
Mailing Address - Country:US
Mailing Address - Phone:817-444-6955
Mailing Address - Fax:817-444-9685
Practice Address - Street 1:405 INWOOD RD
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-4825
Practice Address - Country:US
Practice Address - Phone:940-210-1016
Practice Address - Fax:817-444-9685
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice