Provider Demographics
NPI:1780852632
Name:MICHAELJ HOFFMAN DDS PC
Entity Type:Organization
Organization Name:MICHAELJ HOFFMAN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-247-8730
Mailing Address - Street 1:15340 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-1000
Mailing Address - Country:US
Mailing Address - Phone:586-247-8730
Mailing Address - Fax:586-247-8734
Practice Address - Street 1:15340 23 MILE RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-1000
Practice Address - Country:US
Practice Address - Phone:586-247-8730
Practice Address - Fax:586-247-8734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI161421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty