Provider Demographics
NPI:1942329503
Name:STAUBER, RICHARD ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ARTHUR
Last Name:STAUBER
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 1:26 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:WACCABUC
Mailing Address - State:NY
Mailing Address - Zip Code:10597-1003
Mailing Address - Country:US
Mailing Address - Phone:914-669-5593
Mailing Address - Fax:
Practice Address - Street 1:293 ROUTE 100
Practice Address - Street 2:MILL POND OFFICES, SUITE 202
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-3213
Practice Address - Country:US
Practice Address - Phone:914-277-8400
Practice Address - Fax:914-277-4298
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0378671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice