Provider Demographics
NPI:1144484775
Name:SHUBBER, DALIA H (DDS)
Entity type:Individual
Prefix:DR
First Name:DALIA
Middle Name:H
Last Name:SHUBBER
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 1:1 TRAP FALLS RD STE 401
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4698
Mailing Address - Country:US
Mailing Address - Phone:203-944-9800
Mailing Address - Fax:203-944-9952
Practice Address - Street 1:1 TRAP FALLS RD STE 401
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4698
Practice Address - Country:US
Practice Address - Phone:203-944-9800
Practice Address - Fax:203-944-9952
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-13
Last Update Date:2008-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT88221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice