Provider Demographics
NPI:1770259087
Name:OVO LASIK AND LENS LLC
Entity Type:Organization
Organization Name:OVO LASIK AND LENS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOBANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:763-772-7173
Mailing Address - Street 1:6099 WAYZATA BLVD STE 100-120
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5538
Mailing Address - Country:US
Mailing Address - Phone:952-204-5060
Mailing Address - Fax:
Practice Address - Street 1:6099 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:877-686-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty