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General NPI Number Information
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NPI Number | 1407419963
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Entity Type | Organization
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Legal Business Name | DR. LUBYANSKY DDS, PLLC
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 04/19/2019
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Provider Practice Location Address
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Address Line | 44725 GRAND RIVER AVE
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City | NOVI
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State | MI
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Zip | 48375-1024
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Country | US
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Telephone | 248-476-9121
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Fax |
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Provider Business Mailing Address
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Address Line | 44725 GRAND RIVER AVE
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City | NOVI
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State | MI
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Zip | 48375-1024
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Country | US
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Telephone | 248-476-9121
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALISON LUBYANSKY
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Credential | DDS
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Telephone | 734-276-4902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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