Provider Demographics
NPI:1609848548
Name:DUBOV, ARI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARI
Middle Name:
Last Name:DUBOV
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 1:183 VASSAR ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6034
Mailing Address - Country:US
Mailing Address - Phone:917-951-0202
Mailing Address - Fax:
Practice Address - Street 1:27 MADISON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2722
Practice Address - Country:US
Practice Address - Phone:201-845-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02203700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist