Provider Demographics
NPI:1851320170
Name:MOBLEY, DELMAR (DDS)
Entity Type:Individual
Prefix:
First Name:DELMAR
Middle Name:
Last Name:MOBLEY
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 1:4944 WINDPLAY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9688
Mailing Address - Country:US
Mailing Address - Phone:916-941-2333
Mailing Address - Fax:916-941-6366
Practice Address - Street 1:555 W BENJAMIN HOLT DR
Practice Address - Street 2:SUITE 100
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-3839
Practice Address - Country:US
Practice Address - Phone:209-473-7888
Practice Address - Fax:209-472-2357
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA160121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics