Provider Demographics
NPI:1518081884
Name:HOPKINS, CONNOR BROWN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:BROWN
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:PELZER
Mailing Address - State:SC
Mailing Address - Zip Code:29669-0456
Mailing Address - Country:US
Mailing Address - Phone:864-947-9886
Mailing Address - Fax:864-947-4323
Practice Address - Street 1:112 HIGHWAY 20 S
Practice Address - Street 2:
Practice Address - City:PELZER
Practice Address - State:SC
Practice Address - Zip Code:29669-1509
Practice Address - Country:US
Practice Address - Phone:864-947-9886
Practice Address - Fax:864-947-4323
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ18892Medicaid