Healthcare Provider Details

I. General information

NPI: 1821166596
Provider Name (Legal Business Name): STANLEY L. MUENTER DDS, A DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 EL CAMINO REAL SUITE F
ATASCADERO CA
93422-2700
US

IV. Provider business mailing address

4555 EL CAMINO REAL SUITE F
ATASCADERO CA
93422-2700
US

V. Phone/Fax

Practice location:
  • Phone: 805-461-3147
  • Fax: 805-461-3407
Mailing address:
  • Phone: 805-461-3147
  • Fax: 805-461-3407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number38885
License Number StateCA

VIII. Authorized Official

Name: DR. STANLEY LAURENCE MUENTER
Title or Position: PRESIDENT,OWNER
Credential: DDS
Phone: 805-461-3147