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General NPI Number Information
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NPI Number | 1134773724
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Entity Type | Individual
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Provider Name | AUSTIN IRENE LUNDIN DMD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 1607 W INA RD
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City | TUCSON
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State | AZ
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Zip | 85704-1979
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Country | US
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Telephone | 520-888-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 1607 W INA RD
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City | TUCSON
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State | AZ
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Zip | 85704-1979
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Country | US
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Telephone | 520-888-2900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D11108
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D010878
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License Number State | AZ
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