Provider Demographics
NPI:1811330301
Name:HOPKINS, CHARLES THOMAS III (DMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:THOMAS
Last Name:HOPKINS
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-1666
Mailing Address - Country:US
Mailing Address - Phone:770-468-4685
Mailing Address - Fax:912-634-9819
Practice Address - Street 1:300 MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:SAINT SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-1666
Practice Address - Country:US
Practice Address - Phone:770-468-4685
Practice Address - Fax:912-634-9819
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GADN014669122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program