Provider Demographics
NPI:1548037625
Name:MUNOZ, MARIA TERESA (DMD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:MUNOZ
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 1:175 2ND ST UNIT 904
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4199
Mailing Address - Country:US
Mailing Address - Phone:787-231-4705
Mailing Address - Fax:
Practice Address - Street 1:175 2ND ST UNIT 904
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4199
Practice Address - Country:US
Practice Address - Phone:787-231-4705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02959500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist