Provider Demographics
NPI:1508264094
Name:COFFMAN AND HINKLE, INC.
Entity Type:Organization
Organization Name:COFFMAN AND HINKLE, INC.
Other - Org Name:BUCKHANNON FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-472-1122
Mailing Address - Street 1:14 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2720
Mailing Address - Country:US
Mailing Address - Phone:304-472-1122
Mailing Address - Fax:304-472-1939
Practice Address - Street 1:14 N SPRING ST
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2720
Practice Address - Country:US
Practice Address - Phone:304-472-1122
Practice Address - Fax:304-472-1939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3582122300000X
WV3825122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty