Healthcare Provider Details

I. General information

NPI: 1023319928
Provider Name (Legal Business Name): ANDREW HOFFER D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 SPINNING WHEEL LN
DIX HILLS NY
11746-5010
US

IV. Provider business mailing address

8 SPINNING WHEEL LN
DIX HILLS NY
11746-5010
US

V. Phone/Fax

Practice location:
  • Phone: 631-462-0441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number055846
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: