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General NPI Number Information
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NPI Number | 1730584707
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Entity Type | Organization
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Legal Business Name | HOFFMAN FAMILY DENTISTRY, PLLC
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Dates
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Enumeration Date | 11/03/2014
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 6932 WILLIAMS RD SUITE 1900
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City | NIAGARA FALLS
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State | NY
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Zip | 14094
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Country | US
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Telephone | 716-297-1675
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Fax | 716-297-1676
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Provider Business Mailing Address
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Address Line | 6932 WILLIAMS RD SUITE 1900
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City | NIAGARA FALLS
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State | NY
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Zip | 14094
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Country | US
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Telephone | 716-297-1675
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Fax | 716-297-1676
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Authorized Official
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Title or Position | OWNER
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Name | DR. STACY LOUISE HOFFMAN
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Credential | D.D.S.
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Telephone | 716-297-1675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 054957
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License Number State | NY
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