Provider Demographics
NPI:1912691429
Name:WUBKER, TROY (DMD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:
Last Name:WUBKER
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 1:112 W 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-8708
Mailing Address - Country:US
Mailing Address - Phone:407-580-4436
Mailing Address - Fax:
Practice Address - Street 1:3200 OLD JENNINGS RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-3414
Practice Address - Country:US
Practice Address - Phone:904-505-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL280251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice