Provider Demographics
NPI:1043405939
Name:DUBE FAMILY DENTISTRY INC
Entity Type:Organization
Organization Name:DUBE FAMILY DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:DUBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-352-4422
Mailing Address - Street 1:PO BOX 353
Mailing Address - Street 2:
Mailing Address - City:HANCEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35077
Mailing Address - Country:US
Mailing Address - Phone:256-352-4422
Mailing Address - Fax:
Practice Address - Street 1:508 BANGOR AVE SE
Practice Address - Street 2:
Practice Address - City:HANCEVILLE
Practice Address - State:AL
Practice Address - Zip Code:35277
Practice Address - Country:US
Practice Address - Phone:256-352-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty