Provider Demographics
NPI:1023289287
Name:STEPHEN D. HOBBY DMD PC
Entity type:Organization
Organization Name:STEPHEN D. HOBBY DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-468-9402
Mailing Address - Street 1:500 N IRWIN AVE
Mailing Address - Street 2:
Mailing Address - City:OCILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31774-5008
Mailing Address - Country:US
Mailing Address - Phone:229-468-9402
Mailing Address - Fax:
Practice Address - Street 1:500 N IRWIN AVE
Practice Address - Street 2:
Practice Address - City:OCILLA
Practice Address - State:GA
Practice Address - Zip Code:31774-5008
Practice Address - Country:US
Practice Address - Phone:229-468-9402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN012750122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty