Individual
REBECCA HUBLALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2095 HIGHWAY 211 NW STE 6A, BRASELTON, GA 30517-3403
(770) 756-8442
Mailing address
2095 HIGHWAY 211 NW STE 6A, BRASELTON, GA 30517-3403
(770) 756-8442
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122264
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/24/2020
Last updated
07/29/2021
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