Individual
DR. WALLIS HOBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
120 E COLLEGE AVE, ASHBURN, GA 31714-5209
(229) 326-4801
Mailing address
PO BOX 2569, ASHBURN, GA 31714-2569
(229) 326-4801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013114
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101078
AVESIS
GA
05
—
852444578A
—
GA
01
—
9183415
DORAL
GA
Enumeration date
03/26/2007
Last updated
07/22/2019
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