location
search-icon
institution
Mark D. Thebaut, D.d.s, Pc Dba
Pediatric Dentist in Lilburn, Georgia
NPI 1255665667

Mark D. Thebaut, D.d.s, Pc Dba is a Pediatric Dentist based in Lilburn, GA and is specialized in Pediatric Dentistry. Mark D. Thebaut, D.d.s, Pc Dba practices in Lilburn, GA. The NPI Number for Mark D. Thebaut, D.d.s, Pc Dba is 1255665667 and holds a License No. (Georgia).

The current practice location address for Mark D. Thebaut, D.d.s, Pc Dba is 609 Beaver Ruin Rd, Lilburn, GA and can be reached out via phone at 770-925-3300 and via fax at 770-925-3302.

Location: 609 Beaver Ruin Rd, Lilburn, GA, 30047
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1255665667
Provider Name
Mark D. Thebaut, D.d.s, Pc Dba
Credential
Provider Entity Type
Organization
Address
609 Beaver Ruin Rd, Lilburn, GA, 30047
Phone Number
770-925-3300
Fax Number
770-925-3302
Provider Enumeration Date
10/01/2009
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
151700972A 05 GA
232076497A 05 GA
177273740D 05 GA
149199935A 05 GA
000185875E 05 GA
591447276B 05 GA
institution
Provider Business Practice Location Address Details
Address
609 Beaver Ruin Rd
City
Lilburn
State
Georgia
Zip
30047
Phone Number
770-925-3300
Fax Number
770-925-3302
person
Provider Business Mailing Address Details
Address
609 Beaver Ruin Rd
City
Lilburn
State
Georgia
Zip
30047
Phone Number
770-925-3300
Fax Number
770-925-3302
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
()
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
()
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.
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.