Provider Demographics
NPI:1619146651
Name:MUNRO, JOHN R
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:MUNRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 BELLE FOREST CIR
Mailing Address - Street 2:STE 110
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2112
Mailing Address - Country:US
Mailing Address - Phone:615-371-8878
Mailing Address - Fax:615-371-0153
Practice Address - Street 1:131 BELLE FOREST CIR
Practice Address - Street 2:SUITE 110
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2112
Practice Address - Country:US
Practice Address - Phone:615-662-0255
Practice Address - Fax:615-662-7298
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice