Provider Demographics
NPI:1669661369
Name:STEVEN K. RUBISCH, DDS, PC
Entity Type:Organization
Organization Name:STEVEN K. RUBISCH, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:RUBISCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:928-344-3067
Mailing Address - Street 1:1460 S AVENUE B
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-4332
Mailing Address - Country:US
Mailing Address - Phone:928-344-3067
Mailing Address - Fax:928-782-2323
Practice Address - Street 1:1460 S AVENUE B
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-4332
Practice Address - Country:US
Practice Address - Phone:928-344-3067
Practice Address - Fax:928-782-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD31391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty