Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 07801 | IA |
NPI | 1003817503 |
---|---|
Provider Name | Steven Hopkins |
First Address | Fairfield, IA 52556-2046 |
Second Address | Fairfield, IA 52556-2046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 02/11/2014 |