Provider Demographics
NPI:1013912815
Name:HOFFMANN, PETER (DMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2305
Mailing Address - Country:US
Mailing Address - Phone:814-726-3630
Mailing Address - Fax:814-726-9887
Practice Address - Street 1:211 MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2305
Practice Address - Country:US
Practice Address - Phone:814-726-3630
Practice Address - Fax:814-726-9887
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA19960-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA043202OtherUNITED CONCORDIA