Organization
NORTH SUBURBAN OPTICAL
Active
Other names
Optical Studios
Organization subpart
No
Provider details
NPI number
Authorized official
MARK C LOBANOFF MD (MD/OWNER)
(763) 421-7420
Entity
Organization
Contact information
Practice address
11855 ULYSSES ST, SUITE 140, BLAINE, MN 55434
(763) 421-7420
(763) 421-0730
Mailing address
3777 COON RAPIDS BLVD NW # 100, COON RAPIDS, MN 55433-2630
(763) 421-8524
(763) 421-0730
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/22/2007
Last updated
12/03/2018
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