Provider Demographics
NPI:1053088864
Name:RUBY, MAUREEN FRANCES (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:FRANCES
Last Name:RUBY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MAUREEN
Other - Middle Name:FRANCES
Other - Last Name:MCSPARRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:756B QUINNIPIAC LN
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-8339
Mailing Address - Country:US
Mailing Address - Phone:203-530-0271
Mailing Address - Fax:
Practice Address - Street 1:756B QUINNIPIAC LN
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-8339
Practice Address - Country:US
Practice Address - Phone:203-530-0271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-28
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT61741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice