Provider Demographics
NPI:1194734202
Name:HUBER, ALFRED WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:WILLIAM
Last Name:HUBER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9878 CLINT MOORE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1037
Mailing Address - Country:US
Mailing Address - Phone:561-852-7773
Mailing Address - Fax:561-483-5737
Practice Address - Street 1:9878 CLINT MOORE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-1037
Practice Address - Country:US
Practice Address - Phone:561-852-7773
Practice Address - Fax:561-483-5737
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN110971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice