Provider Demographics
NPI:1629163266
Name:HUBER, DAVID A (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:HUBER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:EVANS CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16033
Mailing Address - Country:US
Mailing Address - Phone:724-538-8480
Mailing Address - Fax:724-538-5411
Practice Address - Street 1:213 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:EVANS CITY
Practice Address - State:PA
Practice Address - Zip Code:16033
Practice Address - Country:US
Practice Address - Phone:724-538-8480
Practice Address - Fax:724-538-5411
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029225-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist