Provider Demographics
NPI:1306973185
Name:WARREN G. HOFFMAN D.D.S. P.A.
Entity type:Organization
Organization Name:WARREN G. HOFFMAN D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-983-4117
Mailing Address - Street 1:435 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE B-101
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7672
Mailing Address - Country:US
Mailing Address - Phone:505-983-4117
Mailing Address - Fax:
Practice Address - Street 1:435 SAINT MICHAELS DR
Practice Address - Street 2:SUITE B-101
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7672
Practice Address - Country:US
Practice Address - Phone:505-983-4117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM19401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty