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NPI 1386037760

NPI 1386037760 : KENNETH RUBENSTEIN D.D.S. : WOODBURY, NY

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General NPI Number Information
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    NPI Number           |    1386037760
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    Entity Type          |    Individual 
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    Provider Name        |    KENNETH RUBENSTEIN D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/10/2015
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    Last Update Date     |    03/10/2015
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Provider Practice Location Address
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    Address Line         |    800 WOODBURY RD SUITE J
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    City                 |    WOODBURY
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    State                |    NY
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    Zip                  |    11797-2503
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    Country              |    US
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    Telephone            |    516-364-3388
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    Fax                  |    516-364-7466
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Provider Business Mailing Address
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    Address Line         |    800 WOODBURY RD SUITE J
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    City                 |    WOODBURY
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    State                |    NY
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    Zip                  |    11797-2503
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    Country              |    US
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    Telephone            |    516-364-3388
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    Fax                  |    512-636-4476
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    24177
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    License Number State |    NY
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