Provider Demographics
NPI:1386708469
Name:HOCHSTATTER, JOEL P (DR)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:P
Last Name:HOCHSTATTER
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:AMBOY
Mailing Address - State:IL
Mailing Address - Zip Code:61310-0110
Mailing Address - Country:US
Mailing Address - Phone:815-857-2015
Mailing Address - Fax:815-857-2333
Practice Address - Street 1:305 E JOE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:AMBOY
Practice Address - State:IL
Practice Address - Zip Code:61310-9492
Practice Address - Country:US
Practice Address - Phone:815-857-2015
Practice Address - Fax:815-857-2333
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist