Provider Demographics
NPI:1922142116
Name:RUBIN, PAUL I (DDS, PA)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:I
Last Name:RUBIN
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1701 LEGACY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5987
Mailing Address - Country:US
Mailing Address - Phone:214-618-5200
Mailing Address - Fax:214-618-5201
Practice Address - Street 1:1701 LEGACY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5987
Practice Address - Country:US
Practice Address - Phone:214-618-5200
Practice Address - Fax:214-618-5201
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198041223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry