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General NPI Number Information
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NPI Number | 1720904485
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Entity Type | Individual
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Provider Name | JORDAN MUNAR
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Gender | Male
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 2601 PAUL JONES ST
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City | GREAT LAKES
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State | IL
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Zip | 60088-2834
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Country | US
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Telephone | 847-688-2430
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Fax |
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Provider Business Mailing Address
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Address Line | 2487 CANYON CREEK RD
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City | ESCONDIDO
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State | CA
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Zip | 92025-7462
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Country | US
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Telephone | 858-444-7306
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14295901-9926
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License Number State | UT
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