Individual
DR. CHARLES EDWIN HUBLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2001 E 70TH ST, SUITE 305, SHREVEPORT, LA 71105-5328
(318) 798-1719
Mailing address
2001 E 70TH ST, SUITE 305, SHREVEPORT, LA 71105-5328
(318) 798-1719
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3773
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D1223
BLUE CROSS BLUE SH. LA
LA
Enumeration date
03/25/2007
Last updated
07/08/2007
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