Provider Demographics
NPI:1033212618
Name:MUNGIA, PEDRO C (DDS)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:C
Last Name:MUNGIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:PETE
Other - Middle Name:C
Other - Last Name:MUNGIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:780 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580
Mailing Address - Country:US
Mailing Address - Phone:956-689-2153
Mailing Address - Fax:956-689-1016
Practice Address - Street 1:780 S 7TH ST
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580
Practice Address - Country:US
Practice Address - Phone:956-689-2153
Practice Address - Fax:956-689-1016
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13371122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist