Provider Demographics
NPI:1952487274
Name:HUBER, RICHARD JOHN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
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:PO BOX 471
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04943-0471
Mailing Address - Country:US
Mailing Address - Phone:207-938-4835
Mailing Address - Fax:
Practice Address - Street 1:24 GREAT MOOSE DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:ME
Practice Address - Zip Code:04943-3022
Practice Address - Country:US
Practice Address - Phone:207-938-4835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME27201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice