Provider Demographics
NPI:1538322680
Name:RUBIN, NORMAN MITCHELL (DDS)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:MITCHELL
Last Name:RUBIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23 ROUTE 111
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3739
Mailing Address - Country:US
Mailing Address - Phone:631-724-3399
Mailing Address - Fax:631-724-4676
Practice Address - Street 1:23 ROUTE 111
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3739
Practice Address - Country:US
Practice Address - Phone:631-724-3399
Practice Address - Fax:631-724-4676
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047835-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist