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General NPI Number Information
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NPI Number | 1699005819
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Entity Type | Organization
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Legal Business Name | LANCASTER DENTAL ASSOCIATES
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 237 W HICKORY ST
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City | LANCASTER
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State | WI
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Zip | 53813-1457
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Country | US
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Telephone | 608-723-2141
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Fax | 608-723-2198
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Provider Business Mailing Address
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Address Line | 237 W HICKORY ST
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City | LANCASTER
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State | WI
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Zip | 53813-1457
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Country | US
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Telephone | 608-723-2141
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Fax | 608-723-2198
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER HOFFMAN
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Credential | DDS
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Telephone | 608-723-2141
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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 | 5911
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2250
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License Number State | WI
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