Provider Demographics
NPI:1689157588
Name:HOP ORTHODONTICS
Entity Type:Organization
Organization Name:HOP ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:V
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:III
Authorized Official - Credentials:MSD, DDS
Authorized Official - Phone:985-893-1044
Mailing Address - Street 1:100 S TYLER ST STE 4
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-3050
Mailing Address - Country:US
Mailing Address - Phone:985-893-1044
Mailing Address - Fax:
Practice Address - Street 1:120 S 28TH AVE
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-7151
Practice Address - Country:US
Practice Address - Phone:601-268-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty