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Individual

DR. JOHN ROBERT LUNDSTROM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
57337 YUCCA TRL, YUCCA VALLEY, CA 92284-3851
(760) 365-7691
Mailing address
57945 CARLYLE DR, YUCCA VALLEY, CA 92284-6210
(319) 594-6132

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
58731
CA
1223E0200X
Endodontics
7627
NC

Other

Enumeration date
02/13/2006
Last updated
10/02/2009
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