Healthcare Provider Details

I. General information

NPI: 1720445232
Provider Name (Legal Business Name): HOFFMAN SMILES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2016
Last Update Date: 01/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 GRAND CANYON PKWY
HOFFMAN ESTATES IL
60169-1739
US

IV. Provider business mailing address

990 GRAND CANYON PKWY
HOFFMAN ESTATES IL
60169-1739
US

V. Phone/Fax

Practice location:
  • Phone: 847-885-1680
  • Fax:
Mailing address:
  • Phone: 847-885-1680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019025308
License Number StateIL

VIII. Authorized Official

Name: DR. DARREN D SIMPSON
Title or Position: PRESIDENT
Credential: DDS
Phone: 708-369-4076