Provider Demographics
NPI:1326539438
Name:HOOPES, BRETT R
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:R
Last Name:HOOPES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7999114-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice