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
Fax: (409) 983-4933
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588662712 NPPES
Texas MEDICAID 126826002

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