Provider Demographics
NPI:1285078501
Name:DOBBS, MARY ELLEN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELLEN
Last Name:DOBBS
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 COLEMAN RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-3809
Mailing Address - Country:US
Mailing Address - Phone:865-588-1644
Mailing Address - Fax:
Practice Address - Street 1:1516 COLEMAN RD
Practice Address - Street 2:SUITE 208
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-3809
Practice Address - Country:US
Practice Address - Phone:865-588-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000090531223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics