Provider Demographics
NPI:1831344399
Name:HOFFLICH, JOEL A (DDS)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:HOFFLICH
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 1:60 JEFFERSON ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-1122
Mailing Address - Country:US
Mailing Address - Phone:845-794-5411
Mailing Address - Fax:845-794-5422
Practice Address - Street 1:60 JEFFERSON ST
Practice Address - Street 2:SUITE 6
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-1122
Practice Address - Country:US
Practice Address - Phone:845-794-5411
Practice Address - Fax:845-794-5422
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0244921223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics