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General NPI Number Information
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NPI Number | 1255987616
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Entity Type | Individual
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Provider Name | KATELYN NOELLE BOBBITT DMD
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Gender | Female
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1406 LUISA ST STE 1
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City | SANTA FE
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State | NM
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Zip | 87505-4161
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Country | US
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Telephone | 505-303-4503
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Fax |
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Provider Business Mailing Address
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Address Line | 6931 WALNUT CREEK RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2833
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Country | US
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Telephone | 479-806-3320
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DD5180
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License Number State | NM
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