Provider Demographics
NPI:1083818157
Name:HUBIS, EMILY OLSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:OLSON
Last Name:HUBIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4513 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8218
Mailing Address - Country:US
Mailing Address - Phone:803-517-3327
Mailing Address - Fax:
Practice Address - Street 1:1025 W MEETING ST
Practice Address - Street 2:STE 100
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2204
Practice Address - Country:US
Practice Address - Phone:803-286-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4329122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist