Provider Demographics
NPI:1518126481
Name:HOFFMAN, MEREDITH CLARK (DMD)
Entity Type:Individual
Prefix:MISS
First Name:MEREDITH
Middle Name:CLARK
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:PO BOX 529
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:31833
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:704 AVE C
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:GA
Practice Address - Zip Code:31833
Practice Address - Country:US
Practice Address - Phone:706-643-3294
Practice Address - Fax:706-643-3296
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013738122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist