Provider Demographics
NPI:1942488663
Name:HOOPES, BRAD (DDS)
Entity Type:Individual
Prefix:
First Name:BRAD
Middle Name:
Last Name:HOOPES
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 1:3300 CHANDLER RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-4957
Mailing Address - Country:US
Mailing Address - Phone:918-682-1055
Mailing Address - Fax:918-682-6436
Practice Address - Street 1:3300 CHANDLER RD
Practice Address - Street 2:SUITE 111
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-4957
Practice Address - Country:US
Practice Address - Phone:918-682-1055
Practice Address - Fax:918-682-6436
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK43651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice