Provider Demographics
NPI:1417045683
Name:HUBER, NANCY A (DDS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:HUBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 COYLE AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-6360
Mailing Address - Country:US
Mailing Address - Phone:916-966-4341
Mailing Address - Fax:916-966-5344
Practice Address - Street 1:6660 COYLE AVE STE 240
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-6360
Practice Address - Country:US
Practice Address - Phone:916-966-4341
Practice Address - Fax:916-966-5344
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice