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General NPI Number Information
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NPI Number | 1902383870
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Entity Type | Individual
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Provider Name | ANDREW LUND DDS
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Gender | Male
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 8454 HIGHWAY 7
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City | ST LOUIS PARK
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State | MN
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Zip | 55426-3900
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Country | US
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Telephone | 952-933-3667
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 HIGHWAY 96 E
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-2620
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Country | US
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Telephone | 651-429-5354
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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 | 14086
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License Number State | MN
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