Provider Demographics
NPI:1144404922
Name:STEPHEN D MUENCH DDS PC
Entity Type:Organization
Organization Name:STEPHEN D MUENCH DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MUENCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-345-3495
Mailing Address - Street 1:46 MIFFLIN ST
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-1318
Mailing Address - Country:US
Mailing Address - Phone:570-345-3495
Mailing Address - Fax:
Practice Address - Street 1:46 MIFFLIN ST
Practice Address - Street 2:
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-1318
Practice Address - Country:US
Practice Address - Phone:570-345-3495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021587L261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental