Provider Demographics
NPI:1336700244
Name:HOFFMAN, JOYANNA MAURINE (DMD)
Entity Type:Individual
Prefix:
First Name:JOYANNA
Middle Name:MAURINE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 GARVEY LN APT 5115
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-1175
Mailing Address - Country:US
Mailing Address - Phone:330-962-8644
Mailing Address - Fax:
Practice Address - Street 1:600 BOYD RD STE B
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-4860
Practice Address - Country:US
Practice Address - Phone:469-565-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-23
Last Update Date:2019-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist