Provider Demographics
NPI:1891933917
Name:HUBBARD, SCOTT THOMAS (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:THOMAS
Last Name:HUBBARD
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:1611 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-3021
Mailing Address - Country:US
Mailing Address - Phone:580-256-7846
Mailing Address - Fax:580-256-2070
Practice Address - Street 1:1611 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3021
Practice Address - Country:US
Practice Address - Phone:580-256-7846
Practice Address - Fax:580-256-2070
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK56851223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics