Provider Demographics
NPI:1497088629
Name:DAVID, REUBEN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:REUBEN
Middle Name:J
Last Name:DAVID
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:REUBEN
Other - Middle Name:J
Other - Last Name:DAVID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1097 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-6505
Mailing Address - Country:US
Mailing Address - Phone:516-931-2290
Mailing Address - Fax:516-931-6608
Practice Address - Street 1:1097 OLD COUNTRY RD
Practice Address - Street 2:SUITE 209
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-6505
Practice Address - Country:US
Practice Address - Phone:516-931-2290
Practice Address - Fax:516-931-6608
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0357031223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics