Provider Demographics
NPI:1366633919
Name:LUND, PETER SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:SCOTT
Last Name:LUND
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 1:257 DENTAL SCIENCE S
Mailing Address - Street 2:UNIVERSITY OF IOWA
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1001
Mailing Address - Country:US
Mailing Address - Phone:319-335-7431
Mailing Address - Fax:319-335-7155
Practice Address - Street 1:322 DENTAL SCIENCE S
Practice Address - Street 2:UNIVERSITY OF IOWA
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1001
Practice Address - Country:US
Practice Address - Phone:319-335-7440
Practice Address - Fax:319-335-7451
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND90091223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics