Provider Demographics
NPI:1952459166
Name:JOHE, RENE S (DMD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:S
Last Name:JOHE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1341
Mailing Address - Country:US
Mailing Address - Phone:973-857-1300
Mailing Address - Fax:973-857-3138
Practice Address - Street 1:35 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1341
Practice Address - Country:US
Practice Address - Phone:973-857-1300
Practice Address - Fax:973-857-3138
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI193991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics