Provider Demographics
NPI:1073820882
Name:LUNDY, TODD EMERY (DDS)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:EMERY
Last Name:LUNDY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-2511
Mailing Address - Country:US
Mailing Address - Phone:641-842-2683
Mailing Address - Fax:
Practice Address - Street 1:112 S 1ST ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-2511
Practice Address - Country:US
Practice Address - Phone:641-842-2683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2015-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA8774122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist