Healthcare Provider Details

I. General information

NPI: 1043350952
Provider Name (Legal Business Name): JAMES F HOFMANN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 E MAIN ST
NEW LEBANON OH
45345-9387
US

IV. Provider business mailing address

PO BOX 184
NEW LEBANON OH
45345-0184
US

V. Phone/Fax

Practice location:
  • Phone: 937-687-1357
  • Fax: 937-687-7518
Mailing address:
  • Phone: 937-687-1357
  • Fax: 937-687-7518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20802
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: