Healthcare Provider Details

I. General information

NPI: 1356361083
Provider Name (Legal Business Name): BURTON PAUL HOFFNER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 W 65TH ST
HIALEAH FL
33012-6719
US

IV. Provider business mailing address

344 W 65TH ST
HIALEAH FL
33012-6719
US

V. Phone/Fax

Practice location:
  • Phone: 305-822-4607
  • Fax: 305-822-5205
Mailing address:
  • Phone: 305-822-4607
  • Fax: 305-822-5205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number005404
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: