Hederman, John Joseph
Hederman, John Joseph is an individual health care provider with primary practice located at 2548 Memorial Blvd , Port Arthur TX 77640-2825. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Hederman, John Joseph can be contacted via phone (409) 983-1161.Contact Information
Primary practice address
2548 Memorial Blvd
Port Arthur TX 77640-2825
Phone: (409) 983-1161
Fax: (409) 983-4933
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 14309 | Texas |
Profile Details
| NPI number | 1588662712 |
|---|---|
| LBN Legal business name | Hederman, John Joseph |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Aug 3rd, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588662712 | NPPES |
| Texas | MEDICAID | 126826002 |
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