Individual
DR. JOHN ZECHARIAH THOBABEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
120 MERIDIAN WAY, SUITE 2, RICHMOND, KY 40475
(859) 361-8058
Mailing address
120 MERIDIAN WAY, SUITE #2, RICHMOND, KY 40475
(859) 361-8058
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
018.001625
IL
1223P0221X
Pediatric Dentistry
Primary
8466
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018.001625
IL TEMPORARY STATE DENTAL LICENSE
IL
05
—
7100082750
—
KY
Enumeration date
08/04/2008
Last updated
08/13/2010
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