| Quinn L. Lundberg, Jr., Dmd | |
|
409 Main St Brockway PA 15824-1324 | |
| (814) 268-6614 | |
| (814) 265-0087 |
| Full Name | Quinn L. Lundberg, Jr., Dmd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 409 Main St, Brockway, Pennsylvania |
| Authorized Official Name and Position | Quinn L Lundberg (OWNER) |
| Authorized Official Contact | 8142686614 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Quinn L. Lundberg, Jr., Dmd 409 Main St Brockway PA 15824-1324 Ph: (814) 268-6614 | Quinn L. Lundberg, Jr., Dmd 409 Main St Brockway PA 15824-1324 Ph: (814) 268-6614 |
| NPI Number | 1801472964 |
|---|---|
| Provider Enumeration Date | 03/19/2021 |
| Last Update Date | 03/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801472964 | NPI | - | NPPES |
| 001248233-0001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |