Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mark D Thebaut, DDS

Individual provider Pediatric Dentistry · NPI 1245332238

Dr. Mark D Thebaut, DDS is a Pediatric Dentistry in Lilburn, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

609 Beaver Ruin Rd NW
Lilburn, GA 30047-3401
Phone: (770) 925-3300
Fax: (770) 925-3302
Show map & directions

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 number1245332238
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedSeptember 1, 2006
Last updated in NPPESJuly 9, 2007
Mailing address609 Beaver Ruin Rd Nw, Lilburn, GA 30047-3401

Other providers in Lilburn