Provider Demographics
NPI:1760131114
Name:HD DENTAL LLC
Entity Type:Organization
Organization Name:HD DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-317-5848
Mailing Address - Street 1:333 2ND ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-7400
Mailing Address - Country:US
Mailing Address - Phone:801-399-9470
Mailing Address - Fax:801-399-5220
Practice Address - Street 1:333 2ND ST STE 1A
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-7400
Practice Address - Country:US
Practice Address - Phone:801-399-9470
Practice Address - Fax:801-399-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty