Provider Demographics
NPI:1578770590
Name:MONICA L. DOBBIN DDS PROFESSIONAL LLC
Entity Type:Organization
Organization Name:MONICA L. DOBBIN DDS PROFESSIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:DOBBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-473-5122
Mailing Address - Street 1:730 CHEYENNE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-2423
Mailing Address - Country:US
Mailing Address - Phone:719-473-5122
Mailing Address - Fax:719-473-3085
Practice Address - Street 1:730 CHEYENNE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-2423
Practice Address - Country:US
Practice Address - Phone:719-473-5122
Practice Address - Fax:719-473-3085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO76331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty