Provider Demographics
NPI:1265650519
Name:HUBBS, TIMOTHY DUANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DUANE
Last Name:HUBBS
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 1:1074 CONCANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6402
Mailing Address - Country:US
Mailing Address - Phone:925-443-7645
Mailing Address - Fax:925-449-2666
Practice Address - Street 1:1074 CONCANNON BLVD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6402
Practice Address - Country:US
Practice Address - Phone:925-443-7645
Practice Address - Fax:925-449-2666
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA447001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice