MEDICARE: DR. KENNETH D RUBINSTEIN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	DN14485	FL

General Provider Information

NPI Number	:	1144380189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH D RUBINSTEIN DMD

Provider Business Mailing Address
First Line	:	10075 S JOG RD STE 108
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3532
Country	:	US
Telephone Number	:	561-738-9007
Fax Number	:	561-738-9963

Provider Business Practice Location Address
First Line	:	10075 S JOG RD STE 108
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3532
Country	:	US
Telephone Number	:	561-738-9007
Fax Number	:	561-738-9963

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	11/15/2017

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