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General NPI Number Information
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NPI Number | 1083248496
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Entity Type | Organization
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Legal Business Name | JESSIE HOFFMAN, DMD, MS, LLC
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 105 W CULVERT ST STE 400
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City | ZELIENOPLE
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State | PA
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Zip | 16063-1513
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Country | US
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Telephone | 412-780-8752
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Fax |
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Provider Business Mailing Address
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Address Line | 4913 WEXFORD RUN RD
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City | BRADFORDWOODS
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State | PA
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Zip | 15015-1327
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JESSIE HOFFMAN
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Credential | DMD
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Telephone | 412-780-8752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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