Mark D Thebaut DDS PC
Mark D Thebaut DDS PC provides Pediatric Dentistry in Lilburn, Georgia. Licensed in Georgia. Registered with an NPI since 2007.
- Licensed in
- GA
- In the registry since
- 2007
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
609 Beaver Ruin Rd NW Ste ALilburn, GA 30047-3401 Not confirmed with CMS for 18 years — call before visiting
Phone: (770) 925-3301
Fax: (770) 709-0001
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatric Dentistry (primary) | Taxonomy 1223P0221X · Licence 9113 (GA) |
|---|
Record details
| NPI number | 1447377130 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mark Thebaut — Owner · (770) 925-3301 |
| Other names | Gwinnett Childrens Dentistry |
| NPI enumerated | March 26, 2007 |
| Last updated in NPPES | June 18, 2008 |
| Mailing address | 609 Beaver Ruin Rd Nw, Suite A, Lilburn, GA 30047-3401 |
Other providers in Lilburn
-
Dr. Belema Abere, DMD
609 Beaver Ruin Rd NW, Lilburn, GA 30047-3401 · (305) 637-6400
-
Platinum Dental Group Lilburn LLC
609 Beaver Ruin Rd Ste A, Lilburn, GA 30047 · (770) 709-0000
-
Dr. Mark D Thebaut, DDS
609 Beaver Ruin Rd NW, Lilburn, GA 30047-3401 · (770) 925-3300