Provider Demographics
NPI:1497886188
Name:MOHN, JEFFREY THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:THOMAS
Last Name:MOHN
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 1:110 WARREN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1566
Mailing Address - Country:US
Mailing Address - Phone:201-447-1116
Mailing Address - Fax:201-493-9115
Practice Address - Street 1:110 WARREN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1566
Practice Address - Country:US
Practice Address - Phone:201-447-1116
Practice Address - Fax:201-493-9115
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022426001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice