Provider Demographics
NPI:1942417332
Name:HOAG, DAVID COUNCIL (DMD DENTIST)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:COUNCIL
Last Name:HOAG
Suffix:
Gender:M
Credentials:DMD DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2465 SOUTH DOWNING
Mailing Address - Street 2:SUITE 208
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5822
Mailing Address - Country:US
Mailing Address - Phone:303-733-0138
Mailing Address - Fax:303-733-6406
Practice Address - Street 1:2465 SOUTH DOWNING
Practice Address - Street 2:SUITE 208
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5822
Practice Address - Country:US
Practice Address - Phone:303-733-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO62041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice