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NPI Code Detail

MEDICARE: CHARLES D. HOFFMAN, DDS, PC

MEDICARE: CHARLES D. HOFFMAN, DDS, PC
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
11223G0001XGeneral Practice DentistryM524SD

General Provider Information

NPI Number : 1841295789
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLES D. HOFFMAN, DDS, PC
Provider Business Mailing Address
First Line : 53 THIRD ST. SW
Second Line : EXECUTIVE BUILDING
City : HURON
State : SD
Zip : 57350
Country : US
Telephone Number : 605-352-3070
Fax Number : 605-352-3411
Provider Business Practice Location Address
First Line : 53 3RD ST SW
Second Line :
City : HURON
State : SD
Zip : 57350-1907
Country : US
Telephone Number : 605-352-3070
Fax Number : 605-352-3411
Authorized Official
Title or Position : PRESIDENT
Name : DR. CHARLES DUANE HOFFMAN
Credential : DDS
Telephone Number : 605-352-3070
Provider Enumeration Date : 06/16/2005
Last Update Date : 08/21/2007

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