Provider Demographics
NPI:1225333586
Name:JOHN W. HOOKER,DDS,PA
Entity Type:Organization
Organization Name:JOHN W. HOOKER,DDS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:JEFFRIES
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-370-4040
Mailing Address - Street 1:1126 N CHURCH ST
Mailing Address - Street 2:102
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1000
Mailing Address - Country:US
Mailing Address - Phone:336-370-4040
Mailing Address - Fax:336-370-4566
Practice Address - Street 1:1126 N CHURCH ST
Practice Address - Street 2:102
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1000
Practice Address - Country:US
Practice Address - Phone:336-370-4040
Practice Address - Fax:336-370-4566
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIAD SMILE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-18
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5498122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty