Provider Demographics
NPI:1619978087
Name:STERN-LUBAHN, CHRISTA LETIZIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:LETIZIA
Last Name:STERN-LUBAHN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-2006
Mailing Address - Country:US
Mailing Address - Phone:231-796-8770
Mailing Address - Fax:231-796-4427
Practice Address - Street 1:106 LOCUST ST
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2006
Practice Address - Country:US
Practice Address - Phone:231-796-8770
Practice Address - Fax:231-796-4427
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI179121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice