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General NPI Number Information
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NPI Number | 1588783880
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Entity Type | Organization
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Legal Business Name | JOSEPH R. RAUB, JR., D.M.D., M.SC.D., P.A.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2122 BIRDCREEK DR
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City | TEMPLE
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State | TX
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Zip | 76502-1020
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Country | US
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Telephone | 254-771-5701
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Fax | 254-771-5770
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Provider Business Mailing Address
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Address Line | PO BOX 3280
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City | TEMPLE
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State | TX
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Zip | 76505-3280
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Country | US
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Telephone | 254-771-5701
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Fax | 254-771-5770
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH REYNOLDS RAUB
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Credential |
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Telephone | 254-771-5701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 18253
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License Number State | TX
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