Provider Demographics
NPI:1629277330
Name:DUBOIS LEBEL, ANDREE-MAUDE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREE-MAUDE
Middle Name:
Last Name:DUBOIS LEBEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 TERRACEVIEW LN N
Mailing Address - Street 2:APT. A
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-6503
Mailing Address - Country:US
Mailing Address - Phone:651-600-8019
Mailing Address - Fax:
Practice Address - Street 1:5901 JOHN MARTIN DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2509
Practice Address - Country:US
Practice Address - Phone:763-585-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND128851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry