Organization
GAYLE Y. LUNDTVEDT, D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYLE Y LUNDTVEDT DMD (PRESIDENT)
(520) 458-4646
Entity
Organization
Contact information
Practice address
1993 FRONTAGE RD, SUITE 208, SIERRA VISTA, AZ 85635-4633
(520) 458-4646
(520) 803-0626
Mailing address
1993 FRONTAGE RD, SUITE 208, SIERRA VISTA, AZ 85635-4633
(520) 458-4646
(520) 803-0626
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D6233
AZ
Other
Enumeration date
01/14/2007
Last updated
12/06/2013
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