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Dr. Peter Lubisich, DDS
Pediatric Dentist in Vancouver, Washington
NPI 1396756029

Peter Lubisich is a Pediatric Dentist based in Vancouver, WA and is specialized in Pediatric Dentistry. Peter Lubisich practices in Vancouver, WA and has the professional credentials of DDS. The NPI Number for Peter Lubisich is 1396756029 and holds a License No. 4438 (Washington).

The current practice location address for Peter Lubisich is 300 Se 120Th Ave Ste 100, Vancouver, WA and can be reached out via phone at 360-256-1755 and via fax at 360-882-8080.

Location: 300 Se 120Th Ave Ste 100, Vancouver, WA, 98683-4067
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Provider Profile Details
NPI Number
1396756029
Provider Name
Peter Lubisich
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
300 Se 120Th Ave Ste 100, Vancouver, WA, 98683-4067
Phone Number
360-256-1755
Fax Number
360-882-8080
Provider Enumeration Date
08/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3798 01 WA WDS ID
409293 01 WA UNITED CONCORDIA/TRICARE
institution
Provider Business Practice Location Address Details
Address
300 Se 120Th Ave Ste 100
City
State
Zip
98683-4067
Phone Number
360-256-1755
Fax Number
360-882-8080
person
Provider Business Mailing Address Details
Address
300 Se 120Th Ave Ste 100
City
State
Zip
98683-4067
Phone Number
360-256-1755
Fax Number
360-882-8080
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
4438 (Washington)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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