Provider Demographics
NPI:1902032170
Name:HOOVER, AMANDA D (RDH)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:D
Last Name:HOOVER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 U.S. ROUTE 23
Mailing Address - Street 2:
Mailing Address - City:PIKETON
Mailing Address - State:OH
Mailing Address - Zip Code:45661
Mailing Address - Country:US
Mailing Address - Phone:740-289-3508
Mailing Address - Fax:740-289-8951
Practice Address - Street 1:7777 U.S. ROUTE 23
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661
Practice Address - Country:US
Practice Address - Phone:740-289-3508
Practice Address - Fax:740-289-8951
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31012706124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist