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DR. LUBNA FAWAD D.D.S

Pediatric Dentistry

Jackson, Mississippi

Provider NPI: 1548273576

Provider Information:
DR. LUBNA  FAWAD D.D.S
Gender: F
Not Sole Proprietor

Practice Location:
2500 N STATE ST  JACKSON, MS 39216 US
Tel: 601-984-6100  Fax: 601-984-6103

Business Mailing Address:
2500 N STATE ST  JACKSON, MS 39216 US
Tel: 601-984-6100  Fax: 601-984-6103

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0221XDental Providers
Dentist
Pediatric Dentistry
MS3351-05

Other Provider Identifiers:

IssuerNumberStateType
00739201MS05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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