North Suburban Optical

NPI #1306042817 in Blaine, Minnesota

Provider Information

NPI Number: 1306042817
Entity Type: Organization
Organization Name: North Suburban Optical
Primary Specialty: Eyewear Supplier
Enumeration Date: Jun 22, 2007
Last Updated: Dec 3, 2018

Practice Location

Address: 11855 ULYSSES ST
Address 2: SUITE 140
City: Blaine
State: Minnesota
ZIP Code: 55434
Phone: (763) 421-7420

Authorized Official

Name: MARK C LOBANOFF, MD
Title: MD/OWNER
Phone: (763) 421-7420

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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