Healthcare Provider Details

I. General information

NPI: 1417093063
Provider Name (Legal Business Name): BRETT ANDREW HOFMANN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 CARLMONT DR SUITE 1
BELMONT CA
94002-3488
US

IV. Provider business mailing address

2120 CARLMONT DR SUITE 1
BELMONT CA
94002-3488
US

V. Phone/Fax

Practice location:
  • Phone: 650-593-2139
  • Fax:
Mailing address:
  • Phone: 650-593-2139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number44699
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: