Healthcare Provider Details

I. General information

NPI: 1851487342
Provider Name (Legal Business Name): BETTINA HOBEICH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12434 WEST ATLANTIC BLVD
CORAL SPRINGS FL
33071
US

IV. Provider business mailing address

12434 WEST ATLANTIC BLVD
CORAL SPRINGS FL
33071
US

V. Phone/Fax

Practice location:
  • Phone: 954-341-1888
  • Fax: 954-341-1666
Mailing address:
  • Phone: 954-341-1888
  • Fax: 954-341-1666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN15985
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: