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NPI Code Detail

MEDICARE: HOFFMAN & UNTERBRUNNER OF MAYFAIR

MEDICARE: HOFFMAN & UNTERBRUNNER OF MAYFAIR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019028024IL

General Provider Information

NPI Number : 1356747927
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOFFMAN & UNTERBRUNNER OF MAYFAIR
Provider Business Mailing Address
First Line : 4401 W LAWRENCE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60630-2510
Country : US
Telephone Number : 773-725-6086
Fax Number :
Provider Business Practice Location Address
First Line : 4401 W LAWRENCE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60630-2510
Country : US
Telephone Number : 773-725-6086
Fax Number :
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : NATHAN HOFFMAN
Credential : DDS
Telephone Number : 773-725-6086
Provider Enumeration Date : 11/10/2014
Last Update Date : 11/10/2014

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Directions to “HOFFMAN & UNTERBRUNNER OF MAYFAIR ” Practice Location

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