Provider Demographics
NPI:1063505154
Name:RUBELING, RICHARD RAPHAEL JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RAPHAEL
Last Name:RUBELING
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 EAST REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-1245
Mailing Address - Country:US
Mailing Address - Phone:859-272-8912
Mailing Address - Fax:658-271-2151
Practice Address - Street 1:200 EAST REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-1245
Practice Address - Country:US
Practice Address - Phone:859-272-8912
Practice Address - Fax:658-271-2151
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4857122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist