Provider Demographics
NPI:1023270782
Name:HUBBARD, KAREN ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANN
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8355 BAYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4427
Mailing Address - Country:US
Mailing Address - Phone:904-733-7254
Mailing Address - Fax:904-731-0144
Practice Address - Street 1:8355 BAYBERRY RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4427
Practice Address - Country:US
Practice Address - Phone:904-733-7254
Practice Address - Fax:904-731-0144
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 136821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74810OtherBLUE CROSS BLUE SHIELD