Provider Demographics
NPI:1699968768
Name:HOFFMAN, CHARLES DUANE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DUANE
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 THIRD ST. SW
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-1954
Mailing Address - Country:US
Mailing Address - Phone:605-352-3070
Mailing Address - Fax:605-352-3411
Practice Address - Street 1:53 3RD ST SW
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-1954
Practice Address - Country:US
Practice Address - Phone:605-352-3070
Practice Address - Fax:605-352-3411
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM5241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice