MEDICARE: DR. STEPHEN DAVID DOBBS D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3297	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	443115	OTHER	PA	UNITED CONCORDIA
2	0153968	OTHER	TN	BLUE CROSS TENNESSEE
3	340769	OTHER		TRIGON BLUE CROSS
4	91777	OTHER	AL	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1326043001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN DAVID DOBBS D.M.D.

Provider Business Mailing Address
First Line	:	417 MAIN ST
Second Line	:
City	:	TRUSSVILLE
State	:	AL
Zip	:	35173-1418
Country	:	US
Telephone Number	:	205-655-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	417 MAIN ST
Second Line	:
City	:	TRUSSVILLE
State	:	AL
Zip	:	35173-1418
Country	:	US
Telephone Number	:	205-655-4300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	07/08/2007

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