Individual
DR. LUBNA FAWAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6100
(601) 984-6103
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6100
(601) 984-6103
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3351-05
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00739201
—
MS
Enumeration date
08/14/2006
Last updated
07/08/2007
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