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General NPI Number Information
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NPI Number | 1750190898
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Entity Type | Organization
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Legal Business Name | HUB CITY DENTALL, LLC
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 22645 AL-59
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City | ROBERTSDALE
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State | AL
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Zip | 36567
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Country | US
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Telephone | 251-621-1370
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Fax |
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Provider Business Mailing Address
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Address Line | 8725 MORPHY AVE
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City | FAIRHOPE
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State | AL
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Zip | 36532-3627
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Country | US
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Telephone | 334-354-4027
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW RICHARDSON
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Credential | DMD
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Telephone | 334-354-4027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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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 |
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License Number State |
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