Provider Demographics
NPI:1780057562
Name:HOFFMAN, LINDSEY (RDH, BSDH)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3477 HUNTER DR
Mailing Address - Street 2:
Mailing Address - City:FRUITPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49415-9326
Mailing Address - Country:US
Mailing Address - Phone:231-578-8553
Mailing Address - Fax:
Practice Address - Street 1:80 W SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-2541
Practice Address - Country:US
Practice Address - Phone:231-733-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902015866124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist