Healthcare Provider Details

I. General information

NPI: 1639525355
Provider Name (Legal Business Name): MITCHELL HOBBS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 PARSONS AVE
COLUMBUS OH
43207-4056
US

IV. Provider business mailing address

3700 PARSONS AVE
COLUMBUS OH
43207-4056
US

V. Phone/Fax

Practice location:
  • Phone: 614-491-5511
  • Fax:
Mailing address:
  • Phone: 614-491-5511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.24719
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: