Provider Demographics
NPI:1578741377
Name:DAVID C. HOBSON, DDS, MS A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DAVID C. HOBSON, DDS, MS A PROFESSIONAL CORPORATION
Other - Org Name:DAVID C. HOBSON, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-662-4555
Mailing Address - Street 1:3250 TRINITY DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2226
Mailing Address - Country:US
Mailing Address - Phone:505-662-4555
Mailing Address - Fax:505-662-4373
Practice Address - Street 1:3250 TRINITY DR
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2226
Practice Address - Country:US
Practice Address - Phone:505-662-4555
Practice Address - Fax:505-662-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD2966305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service