Provider Demographics
NPI:1902665953
Name:GERMAN VILLAGE DENTAL GROUP, NICOLE K. MUNZ, DDS, INC.
Entity Type:Organization
Organization Name:GERMAN VILLAGE DENTAL GROUP, NICOLE K. MUNZ, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MUNZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-444-0417
Mailing Address - Street 1:1084 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-3409
Mailing Address - Country:US
Mailing Address - Phone:614-444-0417
Mailing Address - Fax:614-444-1091
Practice Address - Street 1:1084 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-3409
Practice Address - Country:US
Practice Address - Phone:614-444-0417
Practice Address - Fax:614-444-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty