Healthcare Provider Details

I. General information

NPI: 1750190898
Provider Name (Legal Business Name): HUB CITY DENTALL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22645 AL-59
ROBERTSDALE AL
36567
US

IV. Provider business mailing address

8725 MORPHY AVE
FAIRHOPE AL
36532-3627
US

V. Phone/Fax

Practice location:
  • Phone: 251-621-1370
  • Fax:
Mailing address:
  • Phone: 334-354-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW RICHARDSON
Title or Position: OWNER
Credential: DMD
Phone: 334-354-4027