Provider Demographics
NPI:1558364539
Name:RUBLEY, G DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:G
Middle Name:DAVID
Last Name:RUBLEY
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 1:32 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1966
Mailing Address - Country:US
Mailing Address - Phone:517-278-7436
Mailing Address - Fax:517-279-4633
Practice Address - Street 1:32 DIVISION ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1966
Practice Address - Country:US
Practice Address - Phone:517-278-7436
Practice Address - Fax:517-279-4633
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901009785122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist