Individual
DR. SUSAN ROUBICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
739 WOODROW RD, STATEN ISLAND, NY 10312
(718) 317-8524
Mailing address
21 INDIAN LAKE DRIVE, LITTLE FERRY, NJ 07643
(201) 794-4789
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
044226
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
18098
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DI17158
NJ
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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