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General NPI Number Information
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NPI Number | 1043471683
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Entity Type | Organization
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Legal Business Name | JORGE MUNOZ DMD PA
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 8105 CULEBRA ROAD
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City | SAN ANTONIO
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State | TX
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Zip | 78251-1624
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Country | US
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Telephone | 210-681-9780
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Fax | 210-681-7029
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Provider Business Mailing Address
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Address Line | 8105 CULEBRA ROAD
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City | SAN ANTONIO
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State | TX
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Zip | 78251-1624
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Country | US
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Telephone | 210-681-9780
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Fax | 210-681-7029
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Authorized Official
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Title or Position | OWNER
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Name | JORGE C MUNOZ
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Credential | DMD
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Telephone | 210-681-9780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13580
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 23474
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19985
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License Number State | TX
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