MEDICARE: DR. ILEANA ARIAS-MUNOZ DMD

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
1	1223G0001X	General Practice Dentistry	22DI02266700	NJ

General Provider Information

NPI Number	:	1831300755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ILEANA ARIAS-MUNOZ DMD

Provider Business Mailing Address
First Line	:	6325 PARK AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-4107
Country	:	US
Telephone Number	:	201-861-1090
Fax Number	:	201-861-1057

Provider Business Practice Location Address
First Line	:	6325 PARK AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-4107
Country	:	US
Telephone Number	:	201-861-1090
Fax Number	:	201-861-1057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	12/23/2013

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