MEDICARE: JOSEPH L LUNSFORD DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN0004358	FL

General Provider Information

NPI Number	:	1457499600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH L LUNSFORD DDS, MS

Provider Business Mailing Address
First Line	:	7301A W PALMETTO PARK RD
Second Line	:	SUITE 104C
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3409
Country	:	US
Telephone Number	:	561-391-5126
Fax Number	:	561-391-0445

Provider Business Practice Location Address
First Line	:	6736 FOREST HILL BLVD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33413-3335
Country	:	US
Telephone Number	:	561-964-5200
Fax Number	:	561-969-6612

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	07/08/2007

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