Healthcare Provider Details

I. General information

NPI: 1750494233
Provider Name (Legal Business Name): G DAVID RUBLEY DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 DIVISION ST
COLDWATER MI
49036
US

IV. Provider business mailing address

32 DIVISION ST
COLDWATER MI
49036
US

V. Phone/Fax

Practice location:
  • Phone: 517-278-7436
  • Fax: 517-279-4633
Mailing address:
  • Phone: 517-278-7436
  • Fax: 517-279-4633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number09785
License Number StateMI

VIII. Authorized Official

Name: MRS. CHRISTINE M BROWN
Title or Position: OFFICE MANAGER
Credential:
Phone: 517-278-7436