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NPI Code Detail

MEDICARE: THOMAS K MUN D.D.S.

MEDICARE: THOMAS K MUN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry20429OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154547362
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS K MUN D.D.S.
Provider Business Mailing Address
First Line : 2725 LINCOLN ST E
Second Line :
City : CANTON
State : OH
Zip : 44707-2769
Country : US
Telephone Number : 330-454-2000
Fax Number :
Provider Business Practice Location Address
First Line : 2725 LINCOLN ST E
Second Line :
City : CANTON
State : OH
Zip : 44707-2769
Country : US
Telephone Number : 330-454-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 12/26/2012

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Directions to “ THOMAS K MUN D.D.S.” Practice Location

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