Provider Demographics
NPI:1629565643
Name:HOOPER, PATRICK CHRISTIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:CHRISTIAN
Last Name:HOOPER
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 1:3111 EUBANK BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-4875
Mailing Address - Country:US
Mailing Address - Phone:505-299-5741
Mailing Address - Fax:
Practice Address - Street 1:3111 EUBANK BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-4875
Practice Address - Country:US
Practice Address - Phone:505-299-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD50801223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice