Provider Demographics
NPI:1508955345
Name:LUNDIN, DENNIS CARL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CARL
Last Name:LUNDIN
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 1:1600 COLORADO
Mailing Address - Street 2:BLD 2
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382
Mailing Address - Country:US
Mailing Address - Phone:209-668-7001
Mailing Address - Fax:209-668-1711
Practice Address - Street 1:1600 COLORADO
Practice Address - Street 2:BLD 2
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382
Practice Address - Country:US
Practice Address - Phone:209-668-7001
Practice Address - Fax:209-668-1711
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics