Healthcare Provider Details

I. General information

NPI: 1245205103
Provider Name (Legal Business Name): MICHAEL JOSEPH HOFFMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15340 23 MILE RD
MACOMB MI
48044-1000
US

IV. Provider business mailing address

15340 23 MILE RD
MACOMB MI
48044-1000
US

V. Phone/Fax

Practice location:
  • Phone: 586-247-8730
  • Fax: 586-247-8734
Mailing address:
  • Phone: 586-247-8730
  • Fax: 586-247-8734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number16142
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: