MEDICARE: DR. DAVID A. HUBER D.M.D.

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	DS029225-L	PA

General Provider Information

NPI Number	:	1629163266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A. HUBER D.M.D.

Provider Business Mailing Address
First Line	:	213 EAST MAIN STREET
Second Line	:
City	:	EVANS CITY
State	:	PA
Zip	:	16033
Country	:	US
Telephone Number	:	724-538-8480
Fax Number	:	724-538-5411

Provider Business Practice Location Address
First Line	:	213 EAST MAIN STREET
Second Line	:
City	:	EVANS CITY
State	:	PA
Zip	:	16033
Country	:	US
Telephone Number	:	724-538-8480
Fax Number	:	724-538-5411

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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