Provider Demographics
NPI:1427678002
Name:JESSE J. HOFER, DMD, P.C.
Entity type:Organization
Organization Name:JESSE J. HOFER, DMD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOFER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:914-961-8777
Mailing Address - Street 1:29 PRINCETON ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1326
Mailing Address - Country:US
Mailing Address - Phone:412-758-1864
Mailing Address - Fax:914-961-0325
Practice Address - Street 1:495 CENTRAL PARK AVE STE 302
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1038
Practice Address - Country:US
Practice Address - Phone:914-961-8777
Practice Address - Fax:914-472-8411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty