Provider Demographics
NPI:1366569295
Name:BOCHI, NICOLAS (DMD)
Entity type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:
Last Name:BOCHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 NORTH WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-2126
Mailing Address - Country:US
Mailing Address - Phone:201-384-4454
Mailing Address - Fax:201-384-9829
Practice Address - Street 1:22 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-2126
Practice Address - Country:US
Practice Address - Phone:201-384-4454
Practice Address - Fax:201-384-9829
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI019927001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice