MEDICARE: RICHARD S. LUBELL 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	1223E0200X	Endodontics	DN9270	FL

General Provider Information

NPI Number	:	1669410718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD S. LUBELL DMD

Provider Business Mailing Address
First Line	:	6894 LAKE WORTH RD
Second Line	:	SUITE #202
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-2964
Country	:	US
Telephone Number	:	561-433-4344
Fax Number	:

Provider Business Practice Location Address
First Line	:	6894 LAKE WORTH RD
Second Line	:	SUITE #202
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-2964
Country	:	US
Telephone Number	:	561-433-4344
Fax Number	:

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	07/08/2007

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