Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 4070 | NC |
N | 124Q00000X | Dental Hygienist | 3195 | NC |
N | 126800000X | Dental Assistant |
NPI | 1235152992 |
---|---|
Provider Name | Dr. Richard Lee Hoodenpyle |
First Address | Franklin, NC 28744-0490 |
Second Address | Franklin, NC 28734-7391 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 17/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
94070 | BLUE CROSS/BLUE SHIELD (01) |