Provider Demographics
NPI:1790861177
Name:HOOVER, KEITH ARDEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ARDEN
Last Name:HOOVER
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 1:39 MILFORD DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-2727
Mailing Address - Country:US
Mailing Address - Phone:330-650-0360
Mailing Address - Fax:330-656-9308
Practice Address - Street 1:39 MILFORD DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2727
Practice Address - Country:US
Practice Address - Phone:330-650-0360
Practice Address - Fax:330-656-9308
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice