Healthcare Provider Details

I. General information

NPI: 1174691760
Provider Name (Legal Business Name): ALAN WARREN HOFFMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3351 M ST SUITE 115
MERCED CA
95348-2700
US

IV. Provider business mailing address

3351 M ST SUITE 115
MERCED CA
95348-2700
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-7804
  • Fax: 209-383-9154
Mailing address:
  • Phone: 209-383-7804
  • Fax: 209-383-9154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number23834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: