Provider Demographics
NPI:1104294883
Name:HOBBIE, KRISTI L (DMD)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:L
Last Name:HOBBIE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:L
Other - Last Name:SCHAFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:321 ILLINI DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IL
Mailing Address - Zip Code:61727
Mailing Address - Country:US
Mailing Address - Phone:217-935-5397
Mailing Address - Fax:217-935-4769
Practice Address - Street 1:321 ILLINI DRIVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IL
Practice Address - Zip Code:61727
Practice Address - Country:US
Practice Address - Phone:217-935-5397
Practice Address - Fax:217-935-4769
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.030189122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist