Provider Demographics
NPI:1487745667
Name:HOECKER, KENNETH EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:EDWARD
Last Name:HOECKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 280
Mailing Address - Street 2:820 W.MAIN ST
Mailing Address - City:HEBRON
Mailing Address - State:OH
Mailing Address - Zip Code:43025
Mailing Address - Country:US
Mailing Address - Phone:740-928-4596
Mailing Address - Fax:740-928-0761
Practice Address - Street 1:820 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:OH
Practice Address - Zip Code:43025-9033
Practice Address - Country:US
Practice Address - Phone:740-928-4596
Practice Address - Fax:740-928-0761
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0180251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice