Provider Demographics
NPI:1750125191
Name:HOBBESLAND, REBECCA ALTEMUS (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ALTEMUS
Last Name:HOBBESLAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2319 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-2850
Mailing Address - Country:US
Mailing Address - Phone:918-957-7777
Mailing Address - Fax:
Practice Address - Street 1:2319 N 9TH ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-2850
Practice Address - Country:US
Practice Address - Phone:918-957-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK79251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice