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General NPI Number Information
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NPI Number | 1316179914
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Entity Type | Organization
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Legal Business Name | HUBBARD ORTHODONTICS
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Dates
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Enumeration Date | 08/14/2009
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Last Update Date | 08/14/2009
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Provider Practice Location Address
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Address Line | 1611 MAIN ST SUITE 201
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City | WOODWARD
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State | OK
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Zip | 73801-3021
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Country | US
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Telephone | 580-256-7846
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Fax | 580-256-2070
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Provider Business Mailing Address
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Address Line | 1611 MAIN ST SUITE 201
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City | WOODWARD
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State | OK
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Zip | 73801-3021
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Country | US
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Telephone | 580-256-7846
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Fax | 580-256-2070
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT THOMAS HUBBARD
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Credential | D.D.S., M.S.
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Telephone | 580-256-7846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 174
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License Number State | OK
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