Provider Demographics
NPI:1144629338
Name:HOFFNER, CATHERINE LEROSE (DMD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LEROSE
Last Name:HOFFNER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:ANN
Other - Last Name:LEROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1900 HOLLISTER DR
Mailing Address - Street 2:#190
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5227
Mailing Address - Country:US
Mailing Address - Phone:847-680-0975
Mailing Address - Fax:
Practice Address - Street 1:1900 HOLLISTER DR
Practice Address - Street 2:#190
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5227
Practice Address - Country:US
Practice Address - Phone:847-680-0975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030020122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist