Provider Demographics
NPI:1053032508
Name:PAUL DOBOS, DDS, PLLC
Entity type:Organization
Organization Name:PAUL DOBOS, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-851-8455
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MI
Mailing Address - Zip Code:49285-0093
Mailing Address - Country:US
Mailing Address - Phone:517-851-8455
Mailing Address - Fax:
Practice Address - Street 1:120 E MAIN ST
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MI
Practice Address - Zip Code:49285-9482
Practice Address - Country:US
Practice Address - Phone:517-851-8455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental