Provider Demographics
NPI:1588634281
Name:LOBONO, ADRIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:
Last Name:LOBONO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 6-6837 NORMANDY DRIVE
Mailing Address - Street 2:USA DENTAC
Mailing Address - City:FT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-7302
Mailing Address - Country:US
Mailing Address - Phone:910-643-2196
Mailing Address - Fax:910-643-7017
Practice Address - Street 1:BLDG 6-6837 NORMANDY DRIVE
Practice Address - Street 2:USA DENTAC
Practice Address - City:FT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-7302
Practice Address - Country:US
Practice Address - Phone:910-643-2196
Practice Address - Fax:910-643-7017
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL190267771223G0001X
IL0190267771223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice