Provider Demographics
NPI:1891147187
Name:HOFFSTROM, ANJA M (DDS)
Entity type:Individual
Prefix:DR
First Name:ANJA
Middle Name:M
Last Name:HOFFSTROM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:ANJA
Other - Middle Name:M
Other - Last Name:KOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 STATE HIGHWAY M553
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-9422
Mailing Address - Country:US
Mailing Address - Phone:906-242-2443
Mailing Address - Fax:
Practice Address - Street 1:304 STATE HIGHWAY M553
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-9422
Practice Address - Country:US
Practice Address - Phone:906-242-2443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010219451223G0001X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No1223G0001XDental ProvidersDentistGeneral Practice