Lubisich, Peter
Lubisich, Peter is an individual health care provider with primary practice located at 300 Se 120Th Ave Suite 100, Vancouver WA 98683-4090. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Lubisich, Peter can be contacted via phone (360) 256-1755.Contact Information
Primary practice address
300 Se 120Th Ave Suite 100
Vancouver WA 98683-4090
Phone: (360) 256-1755
Fax: (360) 882-8080
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DE00009724 | Washington |
Profile Details
| NPI number | 1760703821 |
|---|---|
| LBN Legal business name | Lubisich, Peter |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2010 |
| Last updated | Jun 11th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760703821 | NPPES |
| Washington | Other | DE00009724 | STATE LICENSE |
| Washington | MEDICAID | 5046941 | STATE LICENSE |
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