Healthcare Provider Details

I. General information

NPI: 1396877833
Provider Name (Legal Business Name): GREGORY N. HOVANEC DMD PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 VAUXHALL RD
UNION NJ
07083-5823
US

IV. Provider business mailing address

2201 VAUXHALL RD
UNION NJ
07083-5823
US

V. Phone/Fax

Practice location:
  • Phone: 908-687-1211
  • Fax: 908-686-5025
Mailing address:
  • Phone: 908-687-1211
  • Fax: 908-686-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDI013574
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: