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Organization
RUBEN'S DENTAL, PLLC
Active
Organization
RUBEN'S DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUBEN FATTAKHOV DDS (DENTIST)
(718) 760-8400
Entity
Organization
Contact information
Practice address
10510 62ND RD APT 1F, FOREST HILLS, NY 11375-1122
(718) 760-8400
(718) 760-8114
Mailing address
10510 62ND RD APT 1F, FOREST HILLS, NY 11375-1122
(718) 760-8400
(718) 760-8114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
046847
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01709737
—
NY
Enumeration date
04/01/2008
Last updated
04/01/2008
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