Provider Demographics
NPI:1841038452
Name:LUNNING, CALEB MICHAEL (DDS)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:MICHAEL
Last Name:LUNNING
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 1:7674 DESIGN RD
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8439
Mailing Address - Country:US
Mailing Address - Phone:218-828-4816
Mailing Address - Fax:
Practice Address - Street 1:7674 DESIGN RD
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8439
Practice Address - Country:US
Practice Address - Phone:218-828-4816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND151731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice