Provider Demographics
NPI:1730967357
Name:DAN K DUBE DMD PA
Entity type:Organization
Organization Name:DAN K DUBE DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:KAI
Authorized Official - Last Name:DUBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-352-2095
Mailing Address - Street 1:5653 CAROLINA BEACH RD UNIT C1
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5653 CAROLINA BEACH RD UNIT C1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2649
Practice Address - Country:US
Practice Address - Phone:910-791-0986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty