Provider Demographics
NPI:1376507863
Name:MICHAEL G HOPKINS DMD PA
Entity Type:Organization
Organization Name:MICHAEL G HOPKINS DMD PA
Other - Org Name:LAFAYETTE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-579-7888
Mailing Address - Street 1:50 RT 15
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848
Mailing Address - Country:US
Mailing Address - Phone:973-579-7888
Mailing Address - Fax:973-579-7865
Practice Address - Street 1:50 RT 15
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NJ
Practice Address - Zip Code:07848
Practice Address - Country:US
Practice Address - Phone:973-579-7888
Practice Address - Fax:973-579-7865
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHAEL G HOPKINS DMD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-13
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI02246500122300000X
NJDI16081122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty