Provider Demographics
NPI:1447304167
Name:R. RUBIN GUTARTS, D.D.S., M.S., INC.
Entity type:Organization
Organization Name:R. RUBIN GUTARTS, D.D.S., M.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:GUTARTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:440-842-4111
Mailing Address - Street 1:5574 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-2541
Mailing Address - Country:US
Mailing Address - Phone:440-842-4111
Mailing Address - Fax:440-842-3393
Practice Address - Street 1:5574 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-2541
Practice Address - Country:US
Practice Address - Phone:440-842-4111
Practice Address - Fax:440-842-3393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300214341223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty