Provider Demographics
NPI:1437364601
Name:KOBZA, JOHN T (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:KOBZA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:TRAVIS
Other - Last Name:KOBZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:938 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PAWNEE CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68420-3019
Mailing Address - Country:US
Mailing Address - Phone:402-617-1233
Mailing Address - Fax:
Practice Address - Street 1:601 G ST.
Practice Address - Street 2:
Practice Address - City:PAWNEE CITY
Practice Address - State:NE
Practice Address - Zip Code:68420
Practice Address - Country:US
Practice Address - Phone:402-852-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE66361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice