Healthcare Provider Details

I. General information

NPI: 1578741377
Provider Name (Legal Business Name): DAVID C. HOBSON, DDS, MS A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 TRINITY DR
LOS ALAMOS NM
87544-2226
US

IV. Provider business mailing address

3250 TRINITY DR
LOS ALAMOS NM
87544-2226
US

V. Phone/Fax

Practice location:
  • Phone: 505-662-4555
  • Fax: 505-662-4373
Mailing address:
  • Phone: 505-662-4555
  • Fax: 505-662-4373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberDD2966
License Number StateNM

VIII. Authorized Official

Name: DR. DAVID C. HOBSON
Title or Position: PRESIDENT
Credential: DDS
Phone: 505-662-4555