Provider Demographics
NPI:1225148265
Name:MOLSTAD, LYNDA (DDS)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:MOLSTAD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29798 HAUN RD
Mailing Address - Street 2:STE 303
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-6541
Mailing Address - Country:US
Mailing Address - Phone:951-679-7773
Mailing Address - Fax:951-674-5605
Practice Address - Street 1:29798 HAUN RD
Practice Address - Street 2:STE 303
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-6541
Practice Address - Country:US
Practice Address - Phone:951-679-7773
Practice Address - Fax:951-674-5605
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA513621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice