Provider Demographics
NPI:1346402930
Name:HOBBS, RANDI MALIA (D D S)
Entity Type:Individual
Prefix:DR
First Name:RANDI
Middle Name:MALIA
Last Name:HOBBS
Suffix:
Gender:F
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:OK
Mailing Address - Zip Code:73086-4409
Mailing Address - Country:US
Mailing Address - Phone:580-622-6144
Mailing Address - Fax:580-622-5350
Practice Address - Street 1:925 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:OK
Practice Address - Zip Code:73086-4409
Practice Address - Country:US
Practice Address - Phone:580-622-6144
Practice Address - Fax:580-622-5350
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK60281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice