Healthcare Provider Details

I. General information

NPI: 1962829556
Provider Name (Legal Business Name): ART MUNAR DDS P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2014
Last Update Date: 03/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6717 KINGERY HWY
WILLOWBROOK IL
60527-5142
US

IV. Provider business mailing address

6717 KINGERY HWY
WILLOWBROOK IL
60527-5142
US

V. Phone/Fax

Practice location:
  • Phone: 630-655-8781
  • Fax: 630-214-3146
Mailing address:
  • Phone: 630-655-8781
  • Fax: 630-214-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019.021647
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR DUNN MUNAR
Title or Position: OWNER
Credential: D.D.S.
Phone: 630-878-6467