Provider Demographics
NPI:1427369651
Name:HOFER, JESSE J (JESSE HOFER)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:J
Last Name:HOFER
Suffix:
Gender:M
Credentials:JESSE HOFER
Other - Prefix:
Other - First Name:JESSE
Other - Middle Name:
Other - Last Name:HOFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JESSE HOFER
Mailing Address - Street 1:2224 ROUTE 37 E
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-6000
Mailing Address - Country:US
Mailing Address - Phone:732-270-8300
Mailing Address - Fax:732-270-2781
Practice Address - Street 1:2224 ROUTE 37 E
Practice Address - Street 2:SUITE 2
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6000
Practice Address - Country:US
Practice Address - Phone:732-270-8300
Practice Address - Fax:732-270-2781
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024375001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics