Individual
BRIAN LEE LUNDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
655 DARWIN AVE, LOGAN, UT 84321-6156
(435) 752-7442
(435) 752-4929
Mailing address
655 DARWIN AVE, LOGAN, UT 84321-6156
(435) 752-7442
(435) 752-4929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
138906-9922
UT
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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