Provider Demographics
NPI:1316124290
Name:ANEW DENTAL AND ORTHODONTICS, L.L.C.
Entity type:Organization
Organization Name:ANEW DENTAL AND ORTHODONTICS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUBIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-577-9900
Mailing Address - Street 1:13242 S ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-5428
Mailing Address - Country:US
Mailing Address - Phone:815-577-9900
Mailing Address - Fax:815-577-9805
Practice Address - Street 1:13242 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-5428
Practice Address - Country:US
Practice Address - Phone:815-577-9900
Practice Address - Fax:815-577-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty