Provider Demographics
NPI:1235330150
Name:STRUNK, LISA FROST (DDS MS MS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:FROST
Last Name:STRUNK
Suffix:
Gender:F
Credentials:DDS MS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 S 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2869
Mailing Address - Country:US
Mailing Address - Phone:402-330-5913
Mailing Address - Fax:402-333-3190
Practice Address - Street 1:2514 S 119TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2869
Practice Address - Country:US
Practice Address - Phone:402-330-5913
Practice Address - Fax:402-333-3190
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry