Healthcare Provider Details

I. General information

NPI: 1235234063
Provider Name (Legal Business Name): DONALD JOSEPH HOFF JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 STATE HIGHWAY 54 STE 1
SEYMOUR WI
54165
US

IV. Provider business mailing address

344 STATE HIGHWAY 54 STE 1
SEYMOUR WI
54165
US

V. Phone/Fax

Practice location:
  • Phone: 920-833-2215
  • Fax:
Mailing address:
  • Phone: 920-833-2215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberW2493
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: