Mark D Thebaut Dds Pc
Pediatric Dental Clinic
609 Beaver Ruin Rd Nw, Suite A, Lilburn
Georgia, 30047-3401
770-925-3301 770-709-0001
Maps & DirectionsMark D Thebaut Dds Pc is a Pediatric Dental Clinic in Lilburn, Georgia. It is located at 609 Beaver Ruin Rd Nw, Suite A, Lilburn, GA and its contact number is 770-925-3301. The authorized person for Mark D Thebaut Dds Pc is Dr. Mark D Thebaut
who is Owner of the clinic and their contact number is 770-925-3301. The primary license number for Mark D Thebaut Dds Pc is 9113 (Pediatric Dentistry) in Georgia.
Mark D Thebaut Dds Pc Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Mark D Thebaut Dds Pc 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 Dds Pc |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 609 Beaver Ruin Rd Nw, Suite A, Lilburn,
Georgia, 30047-3401 |
| Phone: | 770-925-3301 |
| Fax: | 770-709-0001 |
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: | Dr. Mark D Thebaut |
| Position: | Owner |
| Contact Number: | 770-925-3301 |
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 Dds Pc clinic are as mentioned below.
| NPI Number: | 1447377130 |
| NPI Enumeration Date: | 26 Mar, 2007 |
| NPI Last Update On: | 18 Jun, 2008 |
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 Dds Pc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | 9113 | Georgia | Primary | |
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 Dds Pc
609 Beaver Ruin Rd Nw, Suite A
Lilburn, Georgia |
| Zip: | 30047-3401 |
| Phone Number: | 770-925-3300 |
| Fax Number: | 770-925-3302 |
Patients can reach Mark D Thebaut Dds Pc at
609 Beaver Ruin Rd Nw, Suite A, Lilburn, Georgia or can
call to book an appointment on 770-925-3301.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.