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General NPI Number Information
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NPI Number | 1780667170
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Entity Type | Individual
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Provider Name | THOMAS JOSEPH HOEFFEL D.D.S
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2819 HAMLINE AVE N #104
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City | ROSEVILLE
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State | MN
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Zip | 55113-7129
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Country | US
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Telephone | 651-631-9010
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Fax | 651-631-9011
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Provider Business Mailing Address
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Address Line | 6 PETERSON PL
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City | SAINT PAUL
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State | MN
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Zip | 55127-6201
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Country | US
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Telephone | 651-765-6808
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9606
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License Number State | MN
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