Individual
JOHN LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3515 S 116TH ST, OMAHA, NE 68144-4648
(402) 980-1778
Mailing address
3515 S 116TH ST, OMAHA, NE 68144-4648
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7332
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
04/13/2016
Last updated
01/24/2017
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