Organization
DUBUQUE ENDODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERT LUNDSTROM I D.D.S., M.S. (OWNER/PARTNER)
(563) 583-1050
Entity
Organization
Contact information
Practice address
988 W 3RD ST, SUITE 107, DUBUQUE, IA 52001-6666
(563) 583-1050
Mailing address
988 W 3RD ST, SUITE 107, DUBUQUE, IA 52001-6666
(563) 583-1050
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
DDS-08953
IA
1223E0200X
Endodontics
Primary
DDS-09070
IA
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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