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General NPI Number Information
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NPI Number | 1497130249
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Entity Type | Organization
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Legal Business Name | RUBIX DENTAL GROUP INC
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 8949 RESEDA BLVD STE 116
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3916
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Country | US
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Telephone | 818-280-5596
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Fax | 818-975-5596
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Provider Business Mailing Address
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Address Line | 8949 RESEDA BLVD STE 116
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3916
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Country | US
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Telephone | 818-280-5596
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Fax | 818-975-5596
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. YVETTE S MEDELLIN
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Credential |
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Telephone | 818-280-5596
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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 | 56535
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License Number State | CA
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