Provider Demographics
NPI:1144319872
Name:HUBBARD, LARRY (DDS)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 TPC DR
Mailing Address - Street 2:BLDG. A SUITE 106
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3128
Mailing Address - Country:US
Mailing Address - Phone:972-727-5700
Mailing Address - Fax:972-727-5761
Practice Address - Street 1:6850 TPC DR
Practice Address - Street 2:BLDG. A SUITE 106
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3128
Practice Address - Country:US
Practice Address - Phone:972-727-5700
Practice Address - Fax:972-727-5761
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17851122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist