Provider Demographics
NPI:1528205903
Name:DOBBS, MARION DRENNAN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:DRENNAN
Last Name:DOBBS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:618 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-3612
Mailing Address - Country:US
Mailing Address - Phone:706-647-4633
Mailing Address - Fax:706-647-4567
Practice Address - Street 1:618 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-3612
Practice Address - Country:US
Practice Address - Phone:706-647-4633
Practice Address - Fax:706-647-4567
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA83381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics