Provider Demographics
NPI:1912101205
Name:PLA, LOUBNA C (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:LOUBNA
Middle Name:C
Last Name:PLA
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:DR
Other - First Name:LOUBNA
Other - Middle Name:YOUSSEF
Other - Last Name:CHEHAB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS, MSD
Mailing Address - Street 1:4801 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1166
Mailing Address - Country:US
Mailing Address - Phone:253-473-0101
Mailing Address - Fax:253-473-6328
Practice Address - Street 1:4801 S 19TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1166
Practice Address - Country:US
Practice Address - Phone:253-473-0101
Practice Address - Fax:253-473-6328
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA93061223E0200X
WADE600246731223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics