Healthcare Provider Details

I. General information

NPI: 1700935038
Provider Name (Legal Business Name): NADINE KOBTY D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 US HIGHWAY 131 S
CADILLAC MI
49601-8437
US

IV. Provider business mailing address

7800 US HIGHWAY 131 S P.O. BOX 889
CADILLAC MI
49601-8437
US

V. Phone/Fax

Practice location:
  • Phone: 231-775-9797
  • Fax: 231-775-9793
Mailing address:
  • Phone: 231-775-9797
  • Fax: 231-775-9793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18146
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: