Provider Demographics
NPI:1174639918
Name:HOFFMANN, PAUL EUGENE (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EUGENE
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:988 WEST 3RD ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001
Mailing Address - Country:US
Mailing Address - Phone:563-582-7319
Mailing Address - Fax:563-582-5487
Practice Address - Street 1:988 WEST 3RD ST
Practice Address - Street 2:SUITE 203
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001
Practice Address - Country:US
Practice Address - Phone:563-582-7319
Practice Address - Fax:563-582-5487
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA065941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0172304Medicaid