Provider Demographics
NPI:1598838351
Name:HOFFMANN, KEITH DAVID (DDS PHD)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:DAVID
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:DDS PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1500 E KATELLA AVE
Mailing Address - Street 2:SUITE R
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867
Mailing Address - Country:US
Mailing Address - Phone:714-639-1333
Mailing Address - Fax:714-639-3331
Practice Address - Street 1:1500 E KATELLA AVE
Practice Address - Street 2:SUITE R
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867
Practice Address - Country:US
Practice Address - Phone:714-639-1333
Practice Address - Fax:714-639-3331
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA319281223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery