Organization
LUNDGRIN DENTAL ASSOCIATION CHTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY R LUNDGRIN DDS (PRESIDENT)
(785) 825-5473
Entity
Organization
Contact information
Practice address
909 E WAYNE AVE, SALINA, KS 67401-2201
(785) 825-5473
(785) 825-8965
Mailing address
PO BOX 1424, SALINA, KS 67402-1424
(785) 825-5473
(785) 825-8965
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4696
KS
1223G0001X
General Practice Dentistry
6929
KS
Other
Enumeration date
02/28/2007
Last updated
08/22/2020
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