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NPI 1699899716

NPI 1699899716 : CARLOS MIGUEL MUNOZ D.M.D. : PONCE, PR

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General NPI Number Information
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    NPI Number           |    1699899716
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    Entity Type          |    Individual 
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    Provider Name        |    CARLOS MIGUEL MUNOZ D.M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/16/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2431 AVE LAS AMERICAS PORRATA PILA 202
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    City                 |    PONCE
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    State                |    PR
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    Zip                  |    00717-2113
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    Country              |    US
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    Telephone            |    787-840-0080
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    Fax                  |    787-840-0082
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Provider Business Mailing Address
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    Address Line         |    2431 LAS AMERICAS AVE PORRATA PILA 202
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    City                 |    PONCE
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    State                |    PR
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    Zip                  |    00717-2114
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    Country              |    US
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    Telephone            |    787-840-0080
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    Fax                  |    787-840-0082
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    1330
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    License Number State |    PR
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