Provider Demographics
NPI:1457108946
Name:MOBLEY, REBEKAH LEIGH (DMD)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:LEIGH
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1578 GREENS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1196
Mailing Address - Country:US
Mailing Address - Phone:270-304-1428
Mailing Address - Fax:
Practice Address - Street 1:7668 MALL RD UNIT B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1593
Practice Address - Country:US
Practice Address - Phone:859-568-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY11148122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program