Provider Demographics
NPI:1265631444
Name:JOSEPH L. HVIDDING
Entity Type:Organization
Organization Name:JOSEPH L. HVIDDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:HVIDDING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, FAGD, PA
Authorized Official - Phone:732-681-7400
Mailing Address - Street 1:3100 HIGHWAY 138
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9020
Mailing Address - Country:US
Mailing Address - Phone:732-681-7400
Mailing Address - Fax:
Practice Address - Street 1:3100 HIGHWAY 138
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-9020
Practice Address - Country:US
Practice Address - Phone:732-681-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ115551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty