Provider Demographics
NPI:1417611948
Name:RUBIS DENTAL
Entity Type:Organization
Organization Name:RUBIS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-225-4256
Mailing Address - Street 1:15255 NOONING TREE CT # NA
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4401
Mailing Address - Country:US
Mailing Address - Phone:314-225-4256
Mailing Address - Fax:
Practice Address - Street 1:8938 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-4238
Practice Address - Country:US
Practice Address - Phone:314-225-4256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-31
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty