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Individual

DR. JOSEF W LUBISICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.S.

Contact information

Practice address
300 SE 120TH AVE, STE. 100, VANCOUVER, WA 98683-4090
(360) 256-1755
(360) 882-8080
Mailing address
300 SE 120TH AVE, STE. 100, VANCOUVER, WA 98683-4090
(360) 256-1755
(360) 882-8080

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
D8681
OR
1223P0221X
Pediatric Dentistry
Primary
DE00010088
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5049481
WA
Enumeration date
05/03/2007
Last updated
07/09/2007
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