Provider Demographics
NPI:1609091354
Name:HOCHBERG, MICHAEL J (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:HOCHBERG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 TRIANGLE PARK DRIVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-225-6331
Mailing Address - Fax:603-225-3712
Practice Address - Street 1:9 TRIANGLE PARK DRIVE
Practice Address - Street 2:SUITE 3
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-225-6331
Practice Address - Fax:603-225-3712
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH31551223G0001X
PADS030563L1223G0001X
OH30.0212511223G0001X
NH03155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30306469Medicaid