Provider Demographics
NPI:1952334617
Name:MUENZENBERGER, JAMES R (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:MUENZENBERGER
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 1:139 E CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-2100
Mailing Address - Country:US
Mailing Address - Phone:262-367-2750
Mailing Address - Fax:262-367-6570
Practice Address - Street 1:139 E CAPITOL DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-2100
Practice Address - Country:US
Practice Address - Phone:262-367-2750
Practice Address - Fax:262-367-6570
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice