Mark D. Thebaut, D.d.s, Pc Dba is a Dental Clinic in Lilburn, Georgia. It is located at 609 Beaver Ruin Rd, Suite A, Lilburn, GA and its contact number is 770-925-3300. The authorized person for Mark D. Thebaut, D.d.s, Pc Dba is Mr. Mark Denny Thebaut
who is Owner/dentist of the clinic and their contact number is 678-990-6301. Other organizations associated with this clinic are Mark D. Thebaut, D.d.s, Pc Dba, Platinum Dental Group Lilburn, Llc, Mark D. Thebaut, D.d.s, Pc Dba Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Mark D. Thebaut, D.d.s, Pc Dba Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Mark D. Thebaut, D.d.s, Pc Dba
Specialization:
General Practice Dentistry
Clinic Address:
609 Beaver Ruin Rd, Suite A, Lilburn, Georgia, 30047
Phone:
770-925-3300
Fax:
770-925-3302
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Mr. Mark Denny Thebaut
Position:
Owner/dentist
Contact Number:
678-990-6301
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Mark D. Thebaut, D.d.s, Pc Dba clinic are as mentioned below.
NPI Number:
1255665667
NPI Enumeration Date:
01 Oct, 2009
NPI Last Update On:
01 Oct, 2009
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
Name
Specialization
NPI Number
Mark D. Thebaut, D.d.s, Pc Dba
General Practice Dentistry
1255665667
Platinum Dental Group Lilburn, Llc
General Practice Dentistry
1609100015
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mark D. Thebaut, D.d.s, Pc Dba are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
Primary
General Practice
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
151700972A
Medicaid
Georgia
232076497A
Medicaid
Georgia
177273740D
Medicaid
Georgia
149199935A
Medicaid
Georgia
000185875E
Medicaid
Georgia
591447276B
Medicaid
Georgia
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Mark D. Thebaut, D.d.s, Pc Dba 609 Beaver Ruin Rd, Suite A Lilburn, Georgia
Zip:
30047
Phone Number:
770-925-3300
Fax Number:
770-925-3302
Patients can reach Mark D. Thebaut, D.d.s, Pc Dba at 609 Beaver Ruin Rd, Suite A, Lilburn, Georgia or can call to book an appointment on 770-925-3300. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 March, 2025.