Provider Demographics
NPI:1205248812
Name:MUNEER, QURATULANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:QURATULANNE
Middle Name:
Last Name:MUNEER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:MUNEER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:9359 CENTRAL AVE
Mailing Address - Street 2:SUITE D1
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-2452
Mailing Address - Country:US
Mailing Address - Phone:618-335-2686
Mailing Address - Fax:
Practice Address - Street 1:9359 CENTRAL AVE
Practice Address - Street 2:SUITE D1
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-2452
Practice Address - Country:US
Practice Address - Phone:618-335-2686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-30
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA634201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice