Healthcare Provider Details

I. General information

NPI: 1265587927
Provider Name (Legal Business Name): STEPHEN EDWARD HOFFMANN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C4 CORNWALL CT
EAST BRUNSWICK NJ
08816-3352
US

IV. Provider business mailing address

C4 CORNWALL CT
EAST BRUNSWICK NJ
08816-3352
US

V. Phone/Fax

Practice location:
  • Phone: 732-238-4422
  • Fax: 732-238-0866
Mailing address:
  • Phone: 732-238-4422
  • Fax: 732-238-0866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number22DI01069500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: