Provider Demographics
NPI:1710061080
Name:LUBAR, DAVID M (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:LUBAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 W BROWN DEER RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-1619
Mailing Address - Country:US
Mailing Address - Phone:414-352-7700
Mailing Address - Fax:414-352-7801
Practice Address - Street 1:555 W BROWN DEER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53217-1619
Practice Address - Country:US
Practice Address - Phone:414-352-7700
Practice Address - Fax:414-352-7801
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI 2509-0151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics