Provider Demographics
NPI:1043362684
Name:DONN HUBBARD D.D.S. P.C.
Entity Type:Organization
Organization Name:DONN HUBBARD D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-771-9414
Mailing Address - Street 1:16216 E 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-1524
Mailing Address - Country:US
Mailing Address - Phone:586-771-9414
Mailing Address - Fax:586-772-3468
Practice Address - Street 1:16216 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-1524
Practice Address - Country:US
Practice Address - Phone:586-771-9414
Practice Address - Fax:586-772-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty