| Gayle Y. Lundtvedt, D.m.d., P.c. | |
|
1993 Frontage Rd Suite 208 Sierra Vista AZ 85635-4633 | |
| (520) 458-4646 | |
| (520) 803-0626 |
| Full Name | Gayle Y. Lundtvedt, D.m.d., P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1993 Frontage Rd, Sierra Vista, Arizona |
| Authorized Official Name and Position | Gayle Y Lundtvedt (PRESIDENT) |
| Authorized Official Contact | 5204584646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gayle Y. Lundtvedt, D.m.d., P.c. 1993 Frontage Rd Suite 208 Sierra Vista AZ 85635-4633 Ph: (520) 458-4646 | Gayle Y. Lundtvedt, D.m.d., P.c. 1993 Frontage Rd Suite 208 Sierra Vista AZ 85635-4633 Ph: (520) 458-4646 |
| NPI Number | 1871644211 |
|---|---|
| Provider Enumeration Date | 01/14/2007 |
| Last Update Date | 12/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871644211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D6233 (Arizona) | Primary |
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