Provider Demographics
NPI:1952574725
Name:SUBER, HENRY W (DMD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:W
Last Name:SUBER
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 1:503 MURRAY DR
Mailing Address - Street 2:
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2426
Mailing Address - Country:US
Mailing Address - Phone:864-288-3852
Mailing Address - Fax:
Practice Address - Street 1:503 MURRAY DR
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2426
Practice Address - Country:US
Practice Address - Phone:864-288-3852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1510122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist