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General NPI Number Information
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NPI Number | 1588723696
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Entity Type | Organization
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Legal Business Name | MUNSON AND RUDE PS
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11830 NE 128TH ST SUITE 101
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City | KIRKLAND
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State | WA
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Zip | 98034-7202
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Country | US
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Telephone | 425-821-7100
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Fax | 425-820-8208
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Provider Business Mailing Address
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Address Line | 11830 NE 128TH ST SUITE 101
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City | KIRKLAND
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State | WA
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Zip | 98034-7202
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Country | US
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Telephone | 425-821-7100
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Fax | 425-820-8208
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BOYD F. MUNSON
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Credential | DMD
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Telephone | 425-821-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 7281
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License Number State | WA
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