Provider Demographics
NPI:1386722387
Name:HOBBY, DENNIS WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:WAYNE
Last Name:HOBBY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 COFFEE ROAD
Mailing Address - Street 2:SUITE N
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-4229
Mailing Address - Country:US
Mailing Address - Phone:209-577-0833
Mailing Address - Fax:209-577-3469
Practice Address - Street 1:1213 COFFEE ROAD
Practice Address - Street 2:SUITE N
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4229
Practice Address - Country:US
Practice Address - Phone:209-577-0833
Practice Address - Fax:209-577-3469
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33778122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist