Provider Demographics
NPI:1770795163
Name:HOOVER, REX WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:REX
Middle Name:WILLIAM
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 1:14475 SOBEY RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-5608
Mailing Address - Country:US
Mailing Address - Phone:408-867-4209
Mailing Address - Fax:408-559-5035
Practice Address - Street 1:3990 S BASCOM AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2663
Practice Address - Country:US
Practice Address - Phone:408-356-5161
Practice Address - Fax:408-559-5035
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24119122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist