Provider Demographics
NPI:1184835365
Name:HOPKINTON DENTAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:HOPKINTON DENTAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-435-5455
Mailing Address - Street 1:77 W MAIN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1684
Mailing Address - Country:US
Mailing Address - Phone:508-435-5455
Mailing Address - Fax:508-435-9499
Practice Address - Street 1:77 W MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1684
Practice Address - Country:US
Practice Address - Phone:508-435-5455
Practice Address - Fax:508-435-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20976261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental