Provider Demographics
NPI:1932517588
Name:RUBACH, ALAN CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:CHRISTOPHER
Last Name:RUBACH
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 1:3435 SPRING ST STE 2
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2142
Mailing Address - Country:US
Mailing Address - Phone:563-355-7749
Mailing Address - Fax:563-355-9884
Practice Address - Street 1:3435 SPRING ST STE 2
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807
Practice Address - Country:US
Practice Address - Phone:563-355-7749
Practice Address - Fax:563-355-9884
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-09096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist