Provider Demographics
NPI:1467456723
Name:LUND, WILLIAM COLLINS (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:COLLINS
Last Name:LUND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MAIN ST
Mailing Address - Street 2:STE 225
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3336
Mailing Address - Country:US
Mailing Address - Phone:781-438-2700
Mailing Address - Fax:781-438-8577
Practice Address - Street 1:2 MAIN ST
Practice Address - Street 2:STE 225
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3336
Practice Address - Country:US
Practice Address - Phone:781-438-2700
Practice Address - Fax:781-438-8577
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA129451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice