Provider Demographics
NPI:1578587473
Name:HOBT, DANIEL R (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:R
Last Name:HOBT
Suffix:
Gender:M
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:PO BOX 464
Mailing Address - Street 2:936 SEVENTH ST
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201
Mailing Address - Country:US
Mailing Address - Phone:515-382-6960
Mailing Address - Fax:515-382-6960
Practice Address - Street 1:936 SEVENTH ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201
Practice Address - Country:US
Practice Address - Phone:515-382-6960
Practice Address - Fax:515-382-6960
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA69391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0214361Medicaid