Provider Demographics
NPI:1295415248
Name:HOEFFEL, DALE (DDS)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:
Last Name:HOEFFEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-3125
Mailing Address - Country:US
Mailing Address - Phone:651-260-2873
Mailing Address - Fax:
Practice Address - Street 1:2130 CLIFF RD STE 107
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2486
Practice Address - Country:US
Practice Address - Phone:651-452-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND148861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice