Provider Demographics
NPI:1790719656
Name:STUBBS DDS INC.
Entity Type:Organization
Organization Name:STUBBS DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:COLEMAN
Authorized Official - Last Name:STUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-921-3323
Mailing Address - Street 1:300 TAZEWELL ST
Mailing Address - Street 2:P.O. BOX F
Mailing Address - City:PEARISBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24134-1730
Mailing Address - Country:US
Mailing Address - Phone:540-921-3323
Mailing Address - Fax:
Practice Address - Street 1:300 TAZEWELL ST
Practice Address - Street 2:
Practice Address - City:PEARISBURG
Practice Address - State:VA
Practice Address - Zip Code:24134-1730
Practice Address - Country:US
Practice Address - Phone:540-921-3323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010069171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty