Provider Demographics
NPI:1730248808
Name:LUNDQUIST-TOBIAS, GAIL (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:
Last Name:LUNDQUIST-TOBIAS
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:GAIL
Other - Middle Name:A
Other - Last Name:LUNDQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:373 FRYE FARM RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6479
Mailing Address - Country:US
Mailing Address - Phone:724-537-5570
Mailing Address - Fax:724-537-2774
Practice Address - Street 1:373 FRYE FARM RD
Practice Address - Street 2:SUITE ONE
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6479
Practice Address - Country:US
Practice Address - Phone:724-537-5570
Practice Address - Fax:724-537-2774
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025064L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics