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General NPI Number Information
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NPI Number | 1801441027
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Entity Type | Organization
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Legal Business Name | GERALD L MUNCY D.D.S.
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Dates
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Enumeration Date | 08/05/2019
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 106 PLAZA LOOP SUITE #11
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City | MORENCI
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State | AZ
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Zip | 85540
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Country | US
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Telephone | 928-865-2332
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Fax | 928-865-1218
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Provider Business Mailing Address
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Address Line | PO BOX 99
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City | MORENCI
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State | AZ
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Zip | 85540-0099
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Country | US
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Telephone | 928-865-2332
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Fax | 928-865-1218
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Authorized Official
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Title or Position | FRONT OFFICE
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Name | MRS. LEAH REYES
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Credential |
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Telephone | 928-865-2332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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