Provider Demographics
NPI:1700244167
Name:HOFFMAN, LAURA LEA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEA
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 LAKE WOODMOOR DR
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9074
Mailing Address - Country:US
Mailing Address - Phone:719-488-3014
Mailing Address - Fax:
Practice Address - Street 1:1777 LAKE WOODMOOR DR
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9074
Practice Address - Country:US
Practice Address - Phone:719-488-3014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH000905293124Q00000X
FLDH22195124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist