Provider Demographics
NPI:1629154612
Name:HOOKS, DAN T (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:T
Last Name:HOOKS
Suffix:
Gender:M
Credentials:DDS
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 958
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-0958
Mailing Address - Country:US
Mailing Address - Phone:318-366-9576
Mailing Address - Fax:318-728-2598
Practice Address - Street 1:832 JULIA STRAEET
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-2608
Practice Address - Country:US
Practice Address - Phone:318-728-3831
Practice Address - Fax:318-728-5022
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA28291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1828297Medicaid