Provider Demographics
NPI:1457499600
Name:LUNSFORD, JOSEPH L (DDS, MS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:LUNSFORD
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301A W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 104C
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3409
Mailing Address - Country:US
Mailing Address - Phone:561-391-5126
Mailing Address - Fax:561-391-0445
Practice Address - Street 1:6736 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3335
Practice Address - Country:US
Practice Address - Phone:561-964-5200
Practice Address - Fax:561-969-6612
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00043581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics