Provider Demographics
NPI:1790816585
Name:HOBSON, DONALD (DDS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:HOBSON
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 69
Mailing Address - Street 2:
Mailing Address - City:BIRCH RUN
Mailing Address - State:MI
Mailing Address - Zip Code:48415
Mailing Address - Country:US
Mailing Address - Phone:989-624-4641
Mailing Address - Fax:989-624-0511
Practice Address - Street 1:8155 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BIRCH RUN
Practice Address - State:MI
Practice Address - Zip Code:48415
Practice Address - Country:US
Practice Address - Phone:989-624-4641
Practice Address - Fax:989-624-0511
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI134671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice