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General NPI Number Information
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NPI Number | 1740819903
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Entity Type | Individual
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Provider Name | DIXIE MOBLEY
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Gender | Female
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 05/24/2022
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Provider Practice Location Address
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Address Line | 113 LIELMANIS AVE
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City | HURLBURT FIELD
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State | FL
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Zip | 32544-5613
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Country | US
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Telephone | 850-881-3936
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Fax |
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Provider Business Mailing Address
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Address Line | 1732 ATLANTIC BEACH DR
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City | ATLANTIC BEACH
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State | FL
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Zip | 32233-7329
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Country | US
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Telephone | 561-386-2789
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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 | NONE
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License Number State | FL
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