Provider Demographics
NPI:1164686382
Name:MUNNE, ANNA M (MD, DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:M
Last Name:MUNNE
Suffix:
Gender:F
Credentials:MD, DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4817 MAIN ST
Mailing Address - Street 2:200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-9700
Mailing Address - Country:US
Mailing Address - Phone:713-795-4666
Mailing Address - Fax:713-795-5514
Practice Address - Street 1:4817 MAIN ST
Practice Address - Street 2:200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9700
Practice Address - Country:US
Practice Address - Phone:713-795-4666
Practice Address - Fax:713-795-5514
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179591223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics