Provider Demographics
NPI:1013053552
Name:BOBOTIS, HARRY GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:GEORGE
Last Name:BOBOTIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 CLEVELAND ST
Mailing Address - Street 2:SUITE 2-B
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4427
Mailing Address - Country:US
Mailing Address - Phone:864-233-4874
Mailing Address - Fax:864-233-4868
Practice Address - Street 1:870 CLEVELAND ST
Practice Address - Street 2:SUITE 2-B
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4427
Practice Address - Country:US
Practice Address - Phone:864-233-4874
Practice Address - Fax:864-233-4868
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21541223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics