Individual
DR. JAN BUBLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
210 INDEPENDENCE LN, WAUSAU, WI 54403-5197
(715) 203-1305
(866) 906-0578
Mailing address
210 INDEPENDENCE LN, WAUSAU, WI 54403-5197
(715) 203-1305
(866) 906-0578
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
050499-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161462496
INSURANCE IDENTIFIER
NY
01
—
161762514
INSURANCE IDENTIFIER
NY
01
—
7961
BCBS IDENTIFIER
NY
Enumeration date
09/26/2006
Last updated
04/05/2011
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