Provider Demographics
NPI:1457567372
Name:RUBIN, STUART JOEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:JOEL
Last Name:RUBIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3142
Mailing Address - Country:US
Mailing Address - Phone:973-763-1737
Mailing Address - Fax:973-763-3319
Practice Address - Street 1:730 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3142
Practice Address - Country:US
Practice Address - Phone:973-763-1737
Practice Address - Fax:973-763-3319
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ106991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice