Healthcare Provider Details

I. General information

NPI: 1447455175
Provider Name (Legal Business Name): HOBSON DENTAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7409 WOODRIDGE DR SUITE B
WOODRIDGE IL
60517-2249
US

IV. Provider business mailing address

7409 WOODRIDGE DR SUITE B
WOODRIDGE IL
60517-2249
US

V. Phone/Fax

Practice location:
  • Phone: 630-810-1199
  • Fax: 630-810-9922
Mailing address:
  • Phone: 630-810-1199
  • Fax: 630-810-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. JASON F BROWN
Title or Position: CO-OWNER
Credential: DDS
Phone: 630-810-1199