Mark D Thebaut Dds Pc in Lilburn - Pediatric Dentistry
Mark D Thebaut Dds Pc - NPI 1447377130
Mark D Thebaut Dds Pc is a Pediatric Dentistry in Lilburn, Georgia. Mark D Thebaut Dds Pc practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Mark D Thebaut Dds Pc is 1447377130. The last update date is 2008-06-18.
Mark D Thebaut Dds Pc's current location address is 609 Beaver Ruin Rd Nw, Lilburn, Georgia. You can contact this provider via phone number 7709253301 and fax number 7707090001. The mailing address for Mark D Thebaut Dds Pc is 609 Beaver Ruin Rd Nw, Lilburn, Georgia. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Mark D Thebaut Dds Pc |
---|---|
Address | 609 Beaver Ruin Rd Nw, Lilburn, Georgia |
Phone Number | 7709253301 |
Fax Number | 7707090001 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | OWNER |
---|---|
Authorized Official Name | Thebaut D Mark |
Credentials | DDS |
Telephone Number | 7709253301 |
NPI Number Detail
NPI Number | 1447377130 |
---|---|
Provider Enumeration Date | 2007-03-26 |
Last Updated Date | 2008-06-18 |
Provider Mailing Address Detail
Address | 609 Beaver Ruin Rd Nw |
---|---|
City | Lilburn |
State | Georgia (GA) |
Post Code | 300473401 |
Phone Number | 7709253301 |
Fax Number | 7707090001 |
Provider's Primary Taxonomy Detail
Speciality | Pediatric Dentistry |
---|---|
Taxonomy | 1223P0221X |
Licence No | 9113 |
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Mark D Thebaut Dds Pc by the Centers for Medicare & Medicaid Services?
The Mark D Thebaut Dds Pc has been assigned the NPI (National Provider Identifier) 1447377130 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Mark D Thebaut Dds Pc located?
The Mark D Thebaut Dds Pc is located at 609 Beaver Ruin Rd Nw, Lilburn, GA 300473401.
What is Mark D Thebaut Dds Pc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Mark D Thebaut Dds Pc is Pediatric Dentistry, and the taxonomy code that categorizes this field of expertise is 1223P0221X.
On what date did Mark D Thebaut Dds Pc receive its 1447377130 assignment from the Centers for Medicare & Medicaid Services?
The Mark D Thebaut Dds Pc was assigned its 1447377130 on 2007-03-26, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Mark D Thebaut Dds Pc most recently updated or refreshed?
The details pertaining to the Mark D Thebaut Dds Pc, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-06-18.