Provider Demographics
NPI:1457523128
Name:PAUL J HUBLEY DMD PC
Entity type:Organization
Organization Name:PAUL J HUBLEY DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-872-1422
Mailing Address - Street 1:223 WALNUT ST.
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702
Mailing Address - Country:US
Mailing Address - Phone:508-872-1422
Mailing Address - Fax:508-875-2322
Practice Address - Street 1:223 WALNUT ST.
Practice Address - Street 2:SUITE 6
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-872-1422
Practice Address - Fax:508-875-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA141241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY52604OtherBLUE CROSS BLUE SHIELD