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General NPI Number Information
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NPI Number | 1841331584
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Entity Type | Organization
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Legal Business Name | DRACUT DENTAL GROUP (FORMERLY ZELTAN&RUBN PC)
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 465 NASHUA RD
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City | DRACUT
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State | MA
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Zip | 01826
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Country | US
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Telephone | 978-957-4747
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Fax | 978-957-5662
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Provider Business Mailing Address
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Address Line | 465 NASHUA RD
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City | DRACUT
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State | MA
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Zip | 01826
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Country | US
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Telephone | 978-957-4747
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Fax | 978-957-5662
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE J. RUBIN
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Credential | DMD
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Telephone | 978-957-4747
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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 | 11984
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15490
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18369
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License Number State | MA
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