Provider Demographics
NPI:1174790935
Name:PAUL I RUBIN DDS
Entity type:Organization
Organization Name:PAUL I RUBIN DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:I
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:214-618-5200
Mailing Address - Street 1:1701 LEGACY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-5987
Mailing Address - Country:US
Mailing Address - Phone:214-618-5200
Mailing Address - Fax:214-618-5201
Practice Address - Street 1:1701 LEGACY DR
Practice Address - Street 2:SUITE 110
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5987
Practice Address - Country:US
Practice Address - Phone:214-618-5200
Practice Address - Fax:214-618-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198041223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty