Healthcare Provider Details

I. General information

NPI: 1790816585
Provider Name (Legal Business Name): DONALD HOBSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8155 MAIN STREET
BIRCH RUN MI
48415
US

IV. Provider business mailing address

PO BOX 69
BIRCH RUN MI
48415
US

V. Phone/Fax

Practice location:
  • Phone: 989-624-4641
  • Fax: 989-624-0511
Mailing address:
  • Phone: 989-624-4641
  • Fax: 989-624-0511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13467
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: