Provider Demographics
NPI:1043327711
Name:HOOT, JOSEPH HOMER (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HOMER
Last Name:HOOT
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 1:501 S. TRADE DAYS BLVD.
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:TX
Mailing Address - Zip Code:75103-1824
Mailing Address - Country:US
Mailing Address - Phone:903-567-2666
Mailing Address - Fax:903-567-7527
Practice Address - Street 1:501 S TRADE DAYS BLVD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:TX
Practice Address - Zip Code:75103-1824
Practice Address - Country:US
Practice Address - Phone:903-567-2666
Practice Address - Fax:903-567-7527
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice