Provider Demographics
NPI:1841391364
Name:RUBENS, BRIAN CURTISS (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CURTISS
Last Name:RUBENS
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 1:22232 17TH AVE SE
Mailing Address - Street 2:SUITE 209 CANYON PARK OFFICE CENTER
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7411
Mailing Address - Country:US
Mailing Address - Phone:425-489-8274
Mailing Address - Fax:425-487-9506
Practice Address - Street 1:22232 17TH AVE SE
Practice Address - Street 2:SUITE 209 CANYON PARK OFFICE CENTER
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-7411
Practice Address - Country:US
Practice Address - Phone:425-489-8274
Practice Address - Fax:425-487-9506
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000054791223S0112X
WAGA100001401223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U11530Medicare UPIN