Provider Demographics
NPI:1194798249
Name:HUBERMAN, BRUCE A (DMD)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:A
Last Name:HUBERMAN
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 1:1907 PARK AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5530
Mailing Address - Country:US
Mailing Address - Phone:908-757-4122
Mailing Address - Fax:908-757-1122
Practice Address - Street 1:619 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3553
Practice Address - Country:US
Practice Address - Phone:732-738-6555
Practice Address - Fax:732-738-6565
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ163211223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHU453097Medicare ID - Type Unspecified