Provider Demographics
NPI:1073684189
Name:BOBBE, STEVEN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:BOBBE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:A
Other - Last Name:BOBBE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS PC
Mailing Address - Street 1:1509 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1316
Mailing Address - Country:US
Mailing Address - Phone:708-343-0200
Mailing Address - Fax:708-343-0346
Practice Address - Street 1:1509 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1316
Practice Address - Country:US
Practice Address - Phone:708-343-0200
Practice Address - Fax:708-343-0346
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice