Provider Demographics
NPI:1710001334
Name:HOFF, RANDALL EUGENE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:EUGENE
Last Name:HOFF
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1799 N WATERMAN AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-5107
Mailing Address - Country:US
Mailing Address - Phone:909-883-0024
Mailing Address - Fax:909-886-4684
Practice Address - Street 1:1799 N WATERMAN AVE
Practice Address - Street 2:SUITE G
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-5107
Practice Address - Country:US
Practice Address - Phone:909-883-0024
Practice Address - Fax:909-886-4684
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0319271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics