Provider Demographics
NPI:1770620916
Name:HOFFMAN, CORY MICHAEL (DDS, CAGS)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:MICHAEL
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DDS, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3265 OLD CONEJO RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2152
Mailing Address - Country:US
Mailing Address - Phone:805-480-1999
Mailing Address - Fax:805-480-1911
Practice Address - Street 1:3265 OLD CONEJO RD
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-2152
Practice Address - Country:US
Practice Address - Phone:805-480-1999
Practice Address - Fax:805-480-1911
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA539101223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics