Provider Demographics
NPI:1053759225
Name:HOFELICH, ROBYN M (DMD)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:M
Last Name:HOFELICH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 AVON RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-8340
Mailing Address - Country:US
Mailing Address - Phone:618-806-2744
Mailing Address - Fax:
Practice Address - Street 1:5000 LONGPOINT WAY
Practice Address - Street 2:SUITE 500
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064
Practice Address - Country:US
Practice Address - Phone:615-656-5544
Practice Address - Fax:615-656-5545
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108391223P0221X
RILD00086122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10839OtherTN DENTAL LICENSE