Provider Demographics
NPI:1649650128
Name:MOBLEY, CHRISTIN CARTER
Entity type:Individual
Prefix:DR
First Name:CHRISTIN
Middle Name:CARTER
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 KILLEARN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-3580
Mailing Address - Country:US
Mailing Address - Phone:850-900-1950
Mailing Address - Fax:
Practice Address - Street 1:2304 KILLEARN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-3580
Practice Address - Country:US
Practice Address - Phone:850-666-5365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice