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Individual

DR. HARRY NICK BOBOTIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
112 VILSECK ROAD, BLDG 419-2, FORT STEWART, GA 31315
(912) 257-7056
(912) 257-7055
Mailing address
112 VILSECK ROAD, BLDG 419-2, FORT STEWART, GA 31315
(912) 257-7056
(912) 257-7055

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN011989
GA
1223G0001X
General Practice Dentistry
3490
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Z34909
SC
Enumeration date
05/22/2006
Last updated
07/21/2022
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