Quinn L. Lundberg, Jr., DMD

Organization Active NPI General Practice Dentistry · Brockway, PA

NPI 1801472964 · NPPES record last updated Mar 19, 2021

Key facts

NPI
1801472964
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
QUINN L. LUNDBERG, JR., DMD
Practice address
409 Main St
Brockway, PA 15824-1324
Phone
(814) 268-6614
Fax
(814) 265-0087
NPI assigned
Mar 19, 2021
Organization subpart
No

Authorized official

Name
Dr. Quinn L Lundberg Jr., DMD NPI 1205906617
Title
Owner
Phone
(814) 268-6614

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

409 Main St
Brockway, PA 15824
Phone (814) 268-6614

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

409 Main St
Brockway, PA 15824-1324

Mailing address

409 Main St
Brockway, PA 15824-1324
Phone (814) 268-6614

Other identifiers

IdentifierTypeStateIssuer
001248233-0001MedicaidPA

Other providers in Brockway, PA

All providers in Brockway, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.