Provider Demographics
NPI:1669589875
Name:MUNOZ, JORGE (DMD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8105 CULEBRA ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1634
Mailing Address - Country:US
Mailing Address - Phone:210-681-9780
Mailing Address - Fax:210-681-7029
Practice Address - Street 1:8105 CULEBRA ROAD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1634
Practice Address - Country:US
Practice Address - Phone:210-681-9780
Practice Address - Fax:210-681-7029
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19985122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist