Richard Kubiak, D.D.S., F.A.G.D.

Individual provider Active NPI General Practice Dentistry · Giddings, TX

NPI 1992858146 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992858146
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
11326 (TX)
Practice address
165 S Leon St
Giddings, TX 78942-3313
Phone
(979) 542-3696
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11326TXMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11326 TX Yes

Addresses

Primary practice location

165 S Leon St
Giddings, TX 78942-3313

Mailing address

165 S Leon St
Giddings, TX 78942-3313
Phone (979) 542-3696

Other providers in Giddings, TX

All providers in Giddings, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.