Healthcare Provider Details

I. General information

NPI: 1255031753
Provider Name (Legal Business Name): HOBBS FAMILY DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 FAYETTE ST STE 2B
CONSHOHOCKEN PA
19428-1797
US

IV. Provider business mailing address

612 FAYETTE ST STE 2B
CONSHOHOCKEN PA
19428-1797
US

V. Phone/Fax

Practice location:
  • Phone: 215-873-6072
  • Fax:
Mailing address:
  • Phone: 610-572-1168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNETH C HOBBS
Title or Position: OWNER
Credential: DMD
Phone: 610-572-1168