Provider Demographics
NPI:1558852277
Name:R & R FAMILY DENTISTRY
Entity Type:Organization
Organization Name:R & R FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:ELYSSA
Authorized Official - Last Name:RUBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:563-340-4254
Mailing Address - Street 1:26811 169TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONG GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:52756-9722
Mailing Address - Country:US
Mailing Address - Phone:563-340-4254
Mailing Address - Fax:
Practice Address - Street 1:3435 SPRING ST STE 2
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2142
Practice Address - Country:US
Practice Address - Phone:563-355-7749
Practice Address - Fax:563-355-9884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental