Provider Demographics
NPI:1083720163
Name:RUBENSTEIN, BARRY MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:MARTIN
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15637 GREATER TRL
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-8178
Mailing Address - Country:US
Mailing Address - Phone:352-242-1818
Mailing Address - Fax:352-242-4835
Practice Address - Street 1:1000 EAST AVE
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2534
Practice Address - Country:US
Practice Address - Phone:352-242-1818
Practice Address - Fax:352-242-4835
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL53091223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics