MEDICARE: DR. ELIZABETH ANN HUBBS 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	3112	AR

General Provider Information

NPI Number	:	1861597486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH ANN HUBBS D.D.S.

Provider Business Mailing Address
First Line	:	4001 W FINANCIAL PARKWAY
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-5804
Country	:	US
Telephone Number	:	479-636-8700
Fax Number	:	479-372-4055

Provider Business Practice Location Address
First Line	:	4001 W FINANCIAL PARKWAY
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-5804
Country	:	US
Telephone Number	:	479-636-8700
Fax Number	:	479-372-4055

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	03/09/2016

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