Provider Demographics
NPI:1194234492
Name:HOFFMAN, BRUNA ROSSI (DMD)
Entity type:Individual
Prefix:
First Name:BRUNA
Middle Name:ROSSI
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:BRUNA
Other - Middle Name:
Other - Last Name:ROSSI HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:12 GRANT PL APT 1
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-4407
Mailing Address - Country:US
Mailing Address - Phone:781-879-2754
Mailing Address - Fax:
Practice Address - Street 1:12 GRANT PLACE
Practice Address - Street 2:APT 1
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451
Practice Address - Country:US
Practice Address - Phone:781-879-2754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18577711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice