Provider Demographics
NPI:1225225824
Name:DICK & DUBOFF DENTISTRY
Entity Type:Organization
Organization Name:DICK & DUBOFF DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:DUBOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:802-775-6981
Mailing Address - Street 1:240 STRATTON RD
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4623
Mailing Address - Country:US
Mailing Address - Phone:802-775-6981
Mailing Address - Fax:802-775-1705
Practice Address - Street 1:240 STRATTON RD
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4623
Practice Address - Country:US
Practice Address - Phone:802-775-6981
Practice Address - Fax:802-775-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty