Provider Demographics
NPI:1912089491
Name:HUBNIK, KATHERINE ELAINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ELAINE
Last Name:HUBNIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 W. PEARL ST.
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048
Mailing Address - Country:US
Mailing Address - Phone:817-579-7297
Mailing Address - Fax:817-579-9588
Practice Address - Street 1:915 W. PEARL ST.
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048
Practice Address - Country:US
Practice Address - Phone:817-579-7297
Practice Address - Fax:817-579-9588
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist