Provider Demographics
NPI:1902900467
Name:HOCHSTETLER, GARY LEE (DDS)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:LEE
Last Name:HOCHSTETLER
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 1:113 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:HORTON
Mailing Address - State:KS
Mailing Address - Zip Code:66439-1704
Mailing Address - Country:US
Mailing Address - Phone:785-486-2807
Mailing Address - Fax:785-486-3820
Practice Address - Street 1:113 E 8TH ST
Practice Address - Street 2:
Practice Address - City:HORTON
Practice Address - State:KS
Practice Address - Zip Code:66439-1704
Practice Address - Country:US
Practice Address - Phone:785-486-2807
Practice Address - Fax:785-486-3820
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS64531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice