Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 015074 | MO |
NPI | 1558358176 |
---|---|
Provider Name | Dr. Michael J Hoffmann |
First Address | Saint Louis, MO 63105-2465 |
Second Address | Saint Louis, MO 63105-2465 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 13/08/2013 |