Provider Demographics
NPI:1174700090
Name:HULBERT, DENNIS NELSON (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:NELSON
Last Name:HULBERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6588 PACKER DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:WI
Mailing Address - Zip Code:54121-8368
Mailing Address - Country:US
Mailing Address - Phone:715-528-4998
Mailing Address - Fax:
Practice Address - Street 1:305 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:CRYSTAL FALLS
Practice Address - State:MI
Practice Address - Zip Code:49920-1426
Practice Address - Country:US
Practice Address - Phone:906-875-9599
Practice Address - Fax:906-875-4007
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI123831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice