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NPI Code Detail

MEDICARE: DALE HOFFMANN, P.C.

MEDICARE: DALE HOFFMANN, P.C.
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 : 1548490055
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALE HOFFMANN, P.C.
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 : OWNER
Name : DR. DALE K HOFFMANN
Credential : O.D.
Telephone Number : 719-660-2726
Provider Enumeration Date : 07/17/2009
Last Update Date : 07/17/2009

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Directions to “DALE HOFFMANN, P.C. ” Practice Location

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