MEDICARE: RUBEN CUETO DDS

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	122300000X	Dentist	31359	NY
2	122300000X	Dentist	049728-1	NY

General Provider Information

NPI Number	:	1285997890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUBEN CUETO DDS

Provider Business Mailing Address
First Line	:	278 WILSON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-5140
Country	:	US
Telephone Number	:	718-455-7600
Fax Number	:

Provider Business Practice Location Address
First Line	:	278 WILSON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-5140
Country	:	US
Telephone Number	:	718-455-7600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RUBEN D CUETO
Credential	:	DDS
Telephone Number	:	718-455-7600

Provider Enumeration Date	:	06/19/2012
Last Update Date	:	06/19/2012

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