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Organization
MAIN STREET FAMILY DENTISTRY, PC
Active
Organization
MAIN STREET FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH S HOOVER DMD (OWNER)
(609) 953-7199
Entity
Organization
Contact information
Practice address
76 N MAIN ST, MEDFORD, NJ 08055-2720
(609) 953-7199
Mailing address
76 N MAIN ST, MEDFORD, NJ 08055-2720
(609) 953-7199
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16152
NJ
1223G0001X
General Practice Dentistry
16511
—
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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