Healthcare Provider Details

I. General information

NPI: 1104849207
Provider Name (Legal Business Name): GARY STEPHEN HOFFMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8751 E HAMPDEN AVE
DENVER CO
80231-4952
US

IV. Provider business mailing address

259 SPRUCE ST
DENVER CO
80230-7098
US

V. Phone/Fax

Practice location:
  • Phone: 303-755-4003
  • Fax:
Mailing address:
  • Phone: 303-340-4794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number104199
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: