Provider Demographics
NPI:1851422794
Name:LAWRENCE M RUBIN DMD PC
Entity Type:Organization
Organization Name:LAWRENCE M RUBIN DMD PC
Other - Org Name:LAWRENCE M RUBIN DMD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ENDODONTIST OWNER OF PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PC
Authorized Official - Phone:617-479-7976
Mailing Address - Street 1:250 COPELAND ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169
Mailing Address - Country:US
Mailing Address - Phone:617-479-7976
Mailing Address - Fax:617-479-0776
Practice Address - Street 1:250 COPELAND ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:617-479-7976
Practice Address - Fax:617-479-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA115371223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty