Provider Demographics
NPI:1326222878
Name:UNIVERSITY DENTAL CARE LLC
Entity Type:Organization
Organization Name:UNIVERSITY DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LANNY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-545-1268
Mailing Address - Street 1:61 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2502
Mailing Address - Country:US
Mailing Address - Phone:732-545-1268
Mailing Address - Fax:732-545-4613
Practice Address - Street 1:61 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2502
Practice Address - Country:US
Practice Address - Phone:732-545-1268
Practice Address - Fax:732-545-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ15155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty