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General NPI Number Information
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NPI Number | 1376867077
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Entity Type | Organization
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Legal Business Name | HUBER DENTAL INCORPORATED
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 10/17/2019
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Provider Practice Location Address
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Address Line | 2377 MICHAEL DRIVE
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City | NEWBURY PARK
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State | CA
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Zip | 91320
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Country | US
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Telephone | 805-498-9641
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Fax | 805-498-1981
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Provider Business Mailing Address
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Address Line | 2377 MICHAEL DRIVE
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City | NEWBURY PARK
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State | CA
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Zip | 91320
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Country | US
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Telephone | 805-498-9641
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Fax | 805-498-1981
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD EDWARD HUBER JR.
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Credential | DDS
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Telephone | 805-498-9641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 45707
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 44701
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License Number State | CA
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