Healthcare Provider Details

I. General information

NPI: 1952482564
Provider Name (Legal Business Name): WES SOBEN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 BUFFALO GAP RD STE. D-1
ABILENE TX
79606-3375
US

IV. Provider business mailing address

4601 BUFFALO GAP RD STE. D-1
ABILENE TX
79606-3375
US

V. Phone/Fax

Practice location:
  • Phone: 325-695-3300
  • Fax: 325-695-9899
Mailing address:
  • Phone: 325-695-3300
  • Fax: 325-695-9899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number21408
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: