Healthcare Provider Details

I. General information

NPI: 1285851857
Provider Name (Legal Business Name): LESTER MARC LUBITZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11438 LEBANON PIKE SUITE F
CINCINNATI OH
45241
US

IV. Provider business mailing address

11438 LEBANON PIKE SUITE F
CINCINNATI OH
45241
US

V. Phone/Fax

Practice location:
  • Phone: 513-769-5545
  • Fax:
Mailing address:
  • Phone: 513-769-5545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30-01-4392
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: