Basic Information
Provider Information
NPI: 1528024601
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOF
FirstName: ROBERT
MiddleName: LEE
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2200 SW GAGE BLVD
Address2:  
City: TOPEKA
State: KS
PostalCode: 666220001
CountryCode: US
TelephoneNumber: 7853503111
FaxNumber: 7853504457
Practice Location
Address1: 2200 SW GAGE BLVD
Address2: DENTAL SERVICE
City: TOPEKA
State: KS
PostalCode: 666220001
CountryCode: US
TelephoneNumber: 7853503111
FaxNumber: 7853504457
Other Information
ProviderEnumerationDate: 04/26/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001X6130KSX Dental ProvidersDentistGeneral Practice
1223P0700X6130KSX Dental ProvidersDentistProsthodontics

No ID Information.


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