NPI 1306042817

North Suburban Optical

Organisation Eyewear Supplier Blaine, MN

Practice location

Address: 11855 Ulysses St Suite 140, Blaine, MN 55434
Phone: (763) 421-7420
Fax: (763) 421-0730
Mailing address: 3777 Coon Rapids Blvd NW # 100, Coon Rapids, MN 55433-2630

Authorised official

Name: Mark C Lobanoff
Title: Md/Owner
Phone: (763) 421-7420

Registered specialties

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X

Other Eyewear Supplier providers in Minnesota →

Registry record

NPI: 1306042817
Entity type: Organization
NPI issued: 22 Jun 2007
Record last updated: 3 Dec 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.