Healthcare Provider Details

I. General information

NPI: 1295123529
Provider Name (Legal Business Name): SLATON HOFFNER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2015
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 W WOOD ST
PALATINE IL
60067-7827
US

IV. Provider business mailing address

10401 W LINCOLN AVE STE 101
WEST ALLIS WI
53227-1255
US

V. Phone/Fax

Practice location:
  • Phone: 269-251-2300
  • Fax:
Mailing address:
  • Phone: 269-251-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019.030212
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number137.000929
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number1001070-15
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number1001070-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: