Healthcare Provider Details

I. General information

NPI: 1336560010
Provider Name (Legal Business Name): THOMAS F, HOFF, DDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2013
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E WOODHURST DR BUILDING F SUITE 100
SPRINGFIELD MO
65807-4261
US

IV. Provider business mailing address

1200 E WOODHURST DR BUILDING F SUITE 100
SPRINGFIELD MO
65807-4261
US

V. Phone/Fax

Practice location:
  • Phone: 417-887-3860
  • Fax:
Mailing address:
  • Phone: 417-887-3860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2008014157
License Number StateMO

VIII. Authorized Official

Name: DR. THOMAS F HOFF
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 417-766-6689