Provider Demographics
NPI:1457791071
Name:LUND, HEIDI ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:ANNE
Last Name:LUND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 E HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-1711
Mailing Address - Country:US
Mailing Address - Phone:218-263-8381
Mailing Address - Fax:218-263-8383
Practice Address - Street 1:510 1ST ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371-1604
Practice Address - Country:US
Practice Address - Phone:763-389-1373
Practice Address - Fax:763-389-0538
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13243122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist