Provider Demographics
NPI:1093086043
Name:LUNDY, LIZA M (DMD)
Entity type:Individual
Prefix:DR
First Name:LIZA
Middle Name:M
Last Name:LUNDY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 KIRK RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5933
Mailing Address - Country:US
Mailing Address - Phone:501-448-2386
Mailing Address - Fax:501-421-8098
Practice Address - Street 1:802 KIRK RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5933
Practice Address - Country:US
Practice Address - Phone:501-448-2386
Practice Address - Fax:501-421-8098
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3853122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist