MEDICARE: DR. JOSEPH RAND DUBIN 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	22DI02427500	NJ

General Provider Information

NPI Number	:	1962715243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH RAND DUBIN DDS

Provider Business Mailing Address
First Line	:	1648 ROUTE 130
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-3016
Country	:	US
Telephone Number	:	732-821-7676
Fax Number	:

Provider Business Practice Location Address
First Line	:	1648 ROUTE 130
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-3016
Country	:	US
Telephone Number	:	732-821-7676
Fax Number	:

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

Provider Enumeration Date	:	07/15/2010
Last Update Date	:	07/15/2010

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