Organization
LUNDIN DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LUNDIN DDS (CORPORATION PRESIDENT)
(928) 486-1841
Entity
Organization
Contact information
Practice address
1741 MESQUITE AVENUE STE B 100, LAKE HAVASU CITY, AZ 86403
(928) 855-0556
Mailing address
1741 MESQUITE AVENUE STE B 100, LAKE HAVASU CITY, AZ 86403
(928) 855-0556
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
D03730
AZ
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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