Provider Demographics
NPI:1285912915
Name:DARLING LUND, KATHERINE M (DDS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:DARLING LUND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 ARMY BOULEVARD
Mailing Address - Street 2:APT A
Mailing Address - City:FSH
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:210-221-0835
Mailing Address - Fax:
Practice Address - Street 1:1811 ARMY BLVD
Practice Address - Street 2:US ARMY DENTAL ACTIVITY
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-2686
Practice Address - Country:US
Practice Address - Phone:210-221-0835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND12958122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist