Provider Demographics
NPI:1497879233
Name:DR. KATHARINE M. MUNN, D.D.S., P.C.
Entity Type:Organization
Organization Name:DR. KATHARINE M. MUNN, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHARINE
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:MUNN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-342-4280
Mailing Address - Street 1:64 WHALON STREET
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-7138
Mailing Address - Country:US
Mailing Address - Phone:978-342-4280
Mailing Address - Fax:978-343-4593
Practice Address - Street 1:64 WHALON STREET
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7138
Practice Address - Country:US
Practice Address - Phone:978-342-4280
Practice Address - Fax:978-343-4593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA200311223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty