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General NPI Number Information
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NPI Number | 1538705744
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Entity Type | Organization
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Legal Business Name | CAMERON LUNDIN DENTIST LLC
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 1741 MESQUITE AVE STE 100B
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5686
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Country | US
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Telephone | 928-855-0556
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Fax |
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Provider Business Mailing Address
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Address Line | 1741 MESQUITE AVE STE 100B
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5686
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Country | US
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Telephone | 928-855-0556
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | CAMERON LUNDIN
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Credential | DDS
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Telephone | 928-486-1352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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