Individual
DR. MARK CHARLES HUBERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1214 S 23RD ST, SHEBOYGAN, WI 53081-5012
(920) 457-2419
(920) 457-0262
Mailing address
1214 S 23RD ST, SHEBOYGAN, WI 53081-5012
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3926
WI
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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