Healthcare Provider Details

I. General information

NPI: 1518126481
Provider Name (Legal Business Name): MEREDITH CLARK HOFFMAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 AVE C
WEST POINT GA
31833
US

IV. Provider business mailing address

PO BOX 529
WEST POINT GA
31833
US

V. Phone/Fax

Practice location:
  • Phone: 706-643-3294
  • Fax: 706-643-3296
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN013738
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: