Provider Demographics
NPI:1760856918
Name:MATTHEW L. HUBIS DMD, PA
Entity Type:Organization
Organization Name:MATTHEW L. HUBIS DMD, PA
Other - Org Name:COMPLETE DENTISTRY OF MIDLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-888-0607
Mailing Address - Street 1:12925 HIGHWAY 601
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIDLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28107-9535
Mailing Address - Country:US
Mailing Address - Phone:704-888-0607
Mailing Address - Fax:704-888-0302
Practice Address - Street 1:12925 HIGHWAY 601
Practice Address - Street 2:SUITE 200
Practice Address - City:MIDLAND
Practice Address - State:NC
Practice Address - Zip Code:28107-9535
Practice Address - Country:US
Practice Address - Phone:704-888-0607
Practice Address - Fax:704-888-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-25
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9416122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty