Provider Demographics
NPI:1659185551
Name:R.MICHAEL TUBB DDS
Entity type:Organization
Organization Name:R.MICHAEL TUBB DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TUBB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-682-0200
Mailing Address - Street 1:1220 N TOWN EAST BLVD STE 338
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4683
Mailing Address - Country:US
Mailing Address - Phone:972-682-0200
Mailing Address - Fax:972-682-0866
Practice Address - Street 1:1220 N TOWN EAST BLVD STE 338
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4683
Practice Address - Country:US
Practice Address - Phone:972-682-0200
Practice Address - Fax:972-682-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental