Provider Demographics
NPI:1417068164
Name:P L HOOTON DMD PC
Entity Type:Organization
Organization Name:P L HOOTON DMD PC
Other - Org Name:CAMDEN DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOOTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-882-2005
Mailing Address - Street 1:206 ARNOW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-4071
Mailing Address - Country:US
Mailing Address - Phone:912-882-2005
Mailing Address - Fax:912-882-2342
Practice Address - Street 1:206 ARNOW DR
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4071
Practice Address - Country:US
Practice Address - Phone:912-882-2005
Practice Address - Fax:912-882-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty