Provider Demographics
NPI:1255995965
Name:MUNOZ GUADALUPE, NATALIA MARI (DMD)
Entity type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:MARI
Last Name:MUNOZ GUADALUPE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CALLE DE LA FIDELIDAD URB. EL RETIRO
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-1844
Mailing Address - Country:US
Mailing Address - Phone:787-630-1211
Mailing Address - Fax:
Practice Address - Street 1:240 GEIGER RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1008
Practice Address - Country:US
Practice Address - Phone:215-677-0380
Practice Address - Fax:215-969-0215
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA042112122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist