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General NPI Number Information
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NPI Number | 1518992130
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Entity Type | Individual
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Provider Name | LORETTA KAREN RUBENSTEIN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 12725 MCMANUS BLVD STE 1B
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-4402
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Country | US
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Telephone | 757-874-0990
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Fax | 757-874-7819
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Provider Business Mailing Address
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Address Line | 12725 MCMANUS BLVD STE 1B
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-4402
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Country | US
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Telephone | 757-874-0990
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Fax | 757-874-7819
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401005748
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License Number State | VA
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