Provider Demographics
NPI:1477448132
Name:HOFFMAN DENTAL, LLC
Entity type:Organization
Organization Name:HOFFMAN DENTAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:813-446-6757
Mailing Address - Street 1:3331 E MONTCLAIR ST STE G
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4786
Mailing Address - Country:US
Mailing Address - Phone:417-881-1195
Mailing Address - Fax:417-881-6085
Practice Address - Street 1:3331 E MONTCLAIR ST STE G
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4786
Practice Address - Country:US
Practice Address - Phone:417-881-1195
Practice Address - Fax:417-881-6085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty