Provider Demographics
NPI:1821121039
Name:HOOVER, DEBORAH ANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANNE
Last Name:HOOVER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:ANNE
Other - Last Name:MYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:76 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2720
Mailing Address - Country:US
Mailing Address - Phone:609-953-7199
Mailing Address - Fax:609-953-0314
Practice Address - Street 1:76 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2720
Practice Address - Country:US
Practice Address - Phone:609-953-7199
Practice Address - Fax:609-953-0314
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ165111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice