Provider Demographics
NPI:1932322724
Name:RUBIN, RICHARD LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:RUBIN
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 1:6605 PITTSFORD PALMYRA RD
Mailing Address - Street 2:STE W-3
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3405
Mailing Address - Country:US
Mailing Address - Phone:585-223-4470
Mailing Address - Fax:585-223-4692
Practice Address - Street 1:6605 PITTSFORD PALMYRA RD
Practice Address - Street 2:STE W-3
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-3405
Practice Address - Country:US
Practice Address - Phone:585-223-4470
Practice Address - Fax:585-223-4692
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY386221223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics