Individual
DR. TYLER HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
30 N 18TH AVE, UNIT #2, STURGEON BAY, WI 54235-3207
(920) 743-6911
Mailing address
30 N 18TH AVE, UNIT #2, STURGEON BAY, WI 54235-3207
(920) 743-6911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4722
WI
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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