Provider Demographics
NPI:1689731408
Name:RUBIS, SCOTT ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANTHONY
Last Name:RUBIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15255 NOONING TREE CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4401
Mailing Address - Country:US
Mailing Address - Phone:636-519-7723
Mailing Address - Fax:
Practice Address - Street 1:8938 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-4238
Practice Address - Country:US
Practice Address - Phone:314-427-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0154431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice