Healthcare Provider Details

I. General information

NPI: 1467548347
Provider Name (Legal Business Name): NATALIA HOFFMAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 MAIN ST
WALTHAM MA
02451-7414
US

IV. Provider business mailing address

16 GARRISON RD APT 1
BROOKLINE MA
02445-4420
US

V. Phone/Fax

Practice location:
  • Phone: 781-647-0772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number20723
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: