Provider Demographics
NPI:1174232664
Name:DANIEL J LOBAN DDS PA
Entity type:Organization
Organization Name:DANIEL J LOBAN DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOBAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:218-722-1715
Mailing Address - Street 1:1011 E CENTRAL ENTRANCE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-5545
Mailing Address - Country:US
Mailing Address - Phone:218-722-1715
Mailing Address - Fax:218-727-3217
Practice Address - Street 1:1011 E CENTRAL ENTRANCE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-5545
Practice Address - Country:US
Practice Address - Phone:218-722-1715
Practice Address - Fax:218-727-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty