Doctor Name: | DR. PAUL PHILLIP LUNDINE |
NPI Number: | 1255758819 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.D.S. |
License Number: | 30405 |
Business Practice Address: | 1100 N Lynndale Dr Appleton, WI - 549143011 |
Business Phone Number: | 9207314484 |
Business Fax Number: | 9207312889 |
Mailing Address: | 1100 N Lynndale Dr, APPLETON |
State: | WI |
Postal Code: | 549143011 |
Phone Number: | 9207314484 |
Fax Number: | 9207312889 |
NPI Enumeration Date: | 03/20/2014 |
NPI Last Update Date: | 05/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 30405 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |