Healthcare Provider Details

I. General information

NPI: 1932202512
Provider Name (Legal Business Name): RALPH JULIUS HOFFACKER II DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RALPH JULIUS SOLIDAY HOFFACKER II DDS

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 CARLISLE ST
HANOVER PA
17331-2145
US

IV. Provider business mailing address

565 CARLISLE ST
HANOVER PA
17331-2145
US

V. Phone/Fax

Practice location:
  • Phone: 717-632-8091
  • Fax:
Mailing address:
  • Phone: 717-632-8091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS021339L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: