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NPI Code Detail

MEDICARE: DALE K HOFFMANN O.D.

MEDICARE: DALE K HOFFMANN O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2656MN

General Provider Information

NPI Number : 1396745550
Entity Type Code : Individual
Provider Name (Legal Business Name) : DALE K HOFFMANN O.D.
Provider Business Mailing Address
First Line : 926 W LAKE DR
Second Line :
City : DETROIT LAKES
State : MN
Zip : 56501-4319
Country : US
Telephone Number : 719-660-2726
Fax Number :
Provider Business Practice Location Address
First Line : 1583 HIGHWAY 10 W
Second Line :
City : DETROIT LAKES
State : MN
Zip : 56501-2232
Country : US
Telephone Number : 218-847-7245
Fax Number : 218-847-8453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 07/17/2009

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Directions to “ DALE K HOFFMANN O.D.” Practice Location

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