Provider Demographics
NPI:1538510425
Name:HUBER, ERYN (DDS)
Entity type:Individual
Prefix:
First Name:ERYN
Middle Name:
Last Name:HUBER
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 1:19178 W 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2445
Mailing Address - Country:US
Mailing Address - Phone:734-576-9529
Mailing Address - Fax:248-354-3331
Practice Address - Street 1:19178 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2445
Practice Address - Country:US
Practice Address - Phone:248-354-1555
Practice Address - Fax:248-354-3331
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021887122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist