MEDICARE: DR. JAMES WESLEY MUNN 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	1761	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1881651792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES WESLEY MUNN DMD

Provider Business Mailing Address
First Line	:	PO BOX 218
Second Line	:
City	:	WOODRUFF
State	:	SC
Zip	:	29388-0218
Country	:	US
Telephone Number	:	864-476-2317
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 SJ WORKMAN HWY
Second Line	:
City	:	WOODRUFF
State	:	SC
Zip	:	29388-8942
Country	:	US
Telephone Number	:	864-476-2317
Fax Number	:

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/08/2007

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