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General NPI Number Information
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NPI Number | 1891953493
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Entity Type | Organization
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Legal Business Name | GARY S LUNA DDS
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 1515 S MARSHALL ST
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City | BOONE
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State | IA
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Zip | 50036-5312
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Country | US
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Telephone | 515-432-6063
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 SOUTH MARSHALL STREET
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City | BOONE
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State | IA
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Zip | 50036-5312
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Country | US
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Telephone | 515-432-6063
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GARY S LUNA
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Credential |
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Telephone | 515-432-6063
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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 | 6620
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License Number State | IA
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