Provider Demographics
NPI:1326192832
Name:HOPPER, ALISA MORGAN (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:MORGAN
Last Name:HOPPER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:MORGAN
Other - Last Name:HOPPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:433 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655
Mailing Address - Country:US
Mailing Address - Phone:870-367-7636
Mailing Address - Fax:870-367-7669
Practice Address - Street 1:433 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655
Practice Address - Country:US
Practice Address - Phone:870-367-7636
Practice Address - Fax:870-367-7669
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2843122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist