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NPI Code Detail

MEDICARE: MARY SOBIESK DMD

MEDICARE: MARY SOBIESK DMD
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
11223G0001XGeneral Practice Dentistry111169MS

General Provider Information

NPI Number : 1982599056
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY SOBIESK DMD
Provider Business Mailing Address
First Line : 276 WOODSTONE DR
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-7606
Country : US
Telephone Number : 601-543-5048
Fax Number :
Provider Business Practice Location Address
First Line : 1075 LAKE VILLAGE CIR
Second Line :
City : BRANDON
State : MS
Zip : 39047-6743
Country : US
Telephone Number : 601-992-1605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2025
Last Update Date : 06/10/2025

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Directions to “ MARY SOBIESK DMD” Practice Location

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