MEDICARE: DR. EUPHRA CLARK HUBBS III D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	21316	CA

General Provider Information

NPI Number	:	1447226881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUPHRA CLARK HUBBS III D.D.S.

Provider Business Mailing Address
First Line	:	601 W 5TH ST
Second Line	:	SUITE 755
City	:	LOS ANGELES
State	:	CA
Zip	:	90071-2004
Country	:	US
Telephone Number	:	213-622-3339
Fax Number	:	213-622-4044

Provider Business Practice Location Address
First Line	:	601 W 5TH ST
Second Line	:	SUITE 755
City	:	LOS ANGELES
State	:	CA
Zip	:	90071-2004
Country	:	US
Telephone Number	:	213-622-3339
Fax Number	:	213-622-4044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2006
Last Update Date	:	07/08/2007

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