MEDICARE: DR. ROBERT F HOBDAY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D7811	MN
2	122300000X	Dentist	6610-015	WI

General Provider Information

NPI Number	:	1386632768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT F HOBDAY D.D.S.

Provider Business Mailing Address
First Line	:	6096 259TH ST
Second Line	:
City	:	WYOMING
State	:	MN
Zip	:	55092-7315
Country	:	US
Telephone Number	:	651-272-5153
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 PROGRESS DR
Second Line	:
City	:	NEW LISBON
State	:	WI
Zip	:	53950-1530
Country	:	US
Telephone Number	:	608-562-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	09/26/2017

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