Provider Demographics
NPI:1841597457
Name:LUBO, SAHYLI VERONICE (DDS)
Entity Type:Individual
Prefix:
First Name:SAHYLI
Middle Name:VERONICE
Last Name:LUBO
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 1:1353 W MILL ST.
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92410
Mailing Address - Country:US
Mailing Address - Phone:909-889-7787
Mailing Address - Fax:909-889-2022
Practice Address - Street 1:1353 W MILL ST.
Practice Address - Street 2:SUITE 114
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410
Practice Address - Country:US
Practice Address - Phone:909-889-7787
Practice Address - Fax:909-889-2022
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist