Individual
DR. CHASE A LUNDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4450 W WALTON BLVD, WATERFORD TWP, MI 48329-4093
(248) 600-5827
Mailing address
4450 W WALTON BLVD, WATERFORD TWP, MI 48329-4093
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
147370
AK
122300000X
Dentist
Primary
2901601914
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147370
—
AK
Enumeration date
09/20/2019
Last updated
01/08/2024
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