MEDICARE: DAVID C. HOBSON, DDS, MS A PROFESSIONAL CORPORATION

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	305S00000X	Point of Service	DD2966	NM

General Provider Information

NPI Number	:	1578741377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID C. HOBSON, DDS, MS A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	3250 TRINITY DR
Second Line	:
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-2226
Country	:	US
Telephone Number	:	505-662-4555
Fax Number	:	505-662-4373

Provider Business Practice Location Address
First Line	:	3250 TRINITY DR
Second Line	:
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-2226
Country	:	US
Telephone Number	:	505-662-4555
Fax Number	:	505-662-4373

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID C. HOBSON
Credential	:	DDS
Telephone Number	:	505-662-4555

Provider Enumeration Date	:	02/04/2008
Last Update Date	:	02/04/2008

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