Healthcare Provider Details

I. General information

NPI: 1649294422
Provider Name (Legal Business Name): CARLOS ALBERTO MUNOZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 03/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6436 E WEST VIEW DR
ORANGE CA
92869-4369
US

IV. Provider business mailing address

6436 E WEST VIEW DR
ORANGE CA
92869-4369
US

V. Phone/Fax

Practice location:
  • Phone: 716-536-5752
  • Fax: 716-829-2440
Mailing address:
  • Phone: 716-536-5752
  • Fax: 716-829-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number051909-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number64047
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: