Provider Demographics
NPI:1376527713
Name:MUNSON, DENNIS JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JAMES
Last Name:MUNSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11689 W FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6711
Mailing Address - Country:US
Mailing Address - Phone:314-830-9990
Mailing Address - Fax:314-830-9995
Practice Address - Street 1:11689 W FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6711
Practice Address - Country:US
Practice Address - Phone:314-830-9990
Practice Address - Fax:314-830-9995
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE0151661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice