Individual
DR. BRUCE E HOCHSTADTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021000812 19013612
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
137000100
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080004915
BCBS OF IL GROUP #
—
Enumeration date
09/07/2006
Last updated
07/11/2008
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