Provider Demographics
NPI:1528189214
Name:HUBER, LAURENCE T (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:T
Last Name:HUBER
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 1:7445 SW 115TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4553
Mailing Address - Country:US
Mailing Address - Phone:305-232-0164
Mailing Address - Fax:
Practice Address - Street 1:8833 SW 107TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1411
Practice Address - Country:US
Practice Address - Phone:305-271-1421
Practice Address - Fax:305-271-9640
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN5738122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist