Provider Demographics
NPI:1609145283
Name:MUNARETTO, MICHAEL P (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:MUNARETTO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 S PAULINA ST
Mailing Address - Street 2:304D
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7210
Mailing Address - Country:US
Mailing Address - Phone:847-621-7200
Mailing Address - Fax:847-510-0548
Practice Address - Street 1:605 E ALGONQUIN RD
Practice Address - Street 2:300
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4373
Practice Address - Country:US
Practice Address - Phone:847-621-7200
Practice Address - Fax:847-510-0548
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190286521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice