Individual
JON R LUNDQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
226 N MARKET ST, LIGONIER, PA 15658-1231
(724) 238-9553
Mailing address
226 N MARKET ST, LIGONIER, PA 15658-1231
(724) 238-9553
(814) 723-2355
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS027796L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10037884990001
—
PA
05
—
1018225820001
—
PA
Enumeration date
11/15/2006
Last updated
03/31/2021
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