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General NPI Number Information
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NPI Number | 1851502884
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Entity Type | Organization
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Legal Business Name | HUB CITY ORTHODONTICS, P.A.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 02/07/2021
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Provider Practice Location Address
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Address Line | 1118 KLICK WAY
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City | HAGERSTOWN
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State | MD
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Zip | 21742-3469
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Country | US
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Telephone | 301-733-5230
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Fax | 301-733-5367
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Provider Business Mailing Address
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Address Line | 1118 KLICK WAY
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City | HAGERSTOWN
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State | MD
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Zip | 21742-3469
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Country | US
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Telephone | 301-733-5230
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Fax | 301-733-5367
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. TIMOTHY GERARD WILSON
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Credential | DDS
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Telephone | 301-733-5230
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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 | 11543
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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