MARK D THEBAUT

LILBURN, GA
NPI1245332238
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: GA  9113)
Enumeration Date2006-09-01
Last Update Date2007-07-09
Business Address
Dr. MARK D THEBAUT DDS
609 BEAVER RUIN RD NW
LILBURN, GA 30047-3401
Phone number: 770-925-3300
Mailing Address
Dr. MARK D THEBAUT DDS
609 BEAVER RUIN RD NW
LILBURN, GA 30047-3401
Phone number: 770-925-3300