Provider Demographics
NPI:1023554144
Name:QURATULANNE MUNEER D.M.D., INC
Entity Type:Organization
Organization Name:QURATULANNE MUNEER D.M.D., INC
Other - Org Name:COSMETIC MICRO DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:QURATULANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-962-8828
Mailing Address - Street 1:9359 CENTRAL AVE
Mailing Address - Street 2:SUITE D1
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2452
Mailing Address - Country:US
Mailing Address - Phone:909-962-8828
Mailing Address - Fax:
Practice Address - Street 1:9359 CENTRAL AVE
Practice Address - Street 2:SUITE D1
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2452
Practice Address - Country:US
Practice Address - Phone:909-962-8828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA634201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty