Provider Demographics
NPI:1689824559
Name:HAWKINS, GERALD PERREN (DDS)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:PERREN
Last Name:HAWKINS
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 1:54 FENTON ST.
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4144
Mailing Address - Country:US
Mailing Address - Phone:925-455-1232
Mailing Address - Fax:925-371-6534
Practice Address - Street 1:54 FENTON ST.
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4144
Practice Address - Country:US
Practice Address - Phone:925-455-1232
Practice Address - Fax:925-371-6534
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA210171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice