Provider Demographics
NPI:1881703585
Name:HOFFMAN, CHARLES W (DMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:W
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 UNIVERSITY BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5215
Mailing Address - Country:US
Mailing Address - Phone:561-691-9161
Mailing Address - Fax:561-691-9997
Practice Address - Street 1:1200 UNIVERSITY BLVD
Practice Address - Street 2:STE 103
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5215
Practice Address - Country:US
Practice Address - Phone:561-691-9161
Practice Address - Fax:561-691-9997
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN92321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice