Provider Demographics
NPI:1124039672
Name:BOBADILLA, PATRICIA MARIA (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIA
Last Name:BOBADILLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020
Mailing Address - Country:US
Mailing Address - Phone:954-923-6272
Mailing Address - Fax:
Practice Address - Street 1:2500 E HALLANDALLE BCH BLVD
Practice Address - Street 2:SUITE 601
Practice Address - City:HALLANDALLE
Practice Address - State:FL
Practice Address - Zip Code:33009
Practice Address - Country:US
Practice Address - Phone:954-456-1939
Practice Address - Fax:954-456-1940
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0014173122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist