Provider Demographics
NPI:1851401996
Name:RUBIO, ELSA B (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELSA
Middle Name:B
Last Name:RUBIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 BRIAR WAY
Mailing Address - Street 2:
Mailing Address - City:NESHANIC STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08853
Mailing Address - Country:US
Mailing Address - Phone:732-271-7703
Mailing Address - Fax:732-271-7748
Practice Address - Street 1:1273 BOUND BROOK RD
Practice Address - Street 2:SUITE 9
Practice Address - City:MIDDLESEX
Practice Address - State:NJ
Practice Address - Zip Code:08846-1490
Practice Address - Country:US
Practice Address - Phone:732-271-7703
Practice Address - Fax:732-271-7748
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist