MEDICARE: DR. ALFRED WILLIAM HUBER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN11097	FL

General Provider Information

NPI Number	:	1194734202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFRED WILLIAM HUBER D.D.S.

Provider Business Mailing Address
First Line	:	9878 CLINT MOORE RD
Second Line	:	SUITE 200
City	:	BOCA RATON
State	:	FL
Zip	:	33496-1037
Country	:	US
Telephone Number	:	561-852-7773
Fax Number	:	561-483-5737

Provider Business Practice Location Address
First Line	:	9878 CLINT MOORE RD
Second Line	:	SUITE 200
City	:	BOCA RATON
State	:	FL
Zip	:	33496-1037
Country	:	US
Telephone Number	:	561-852-7773
Fax Number	:	561-483-5737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	12/18/2015

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