Provider Demographics
NPI:1861793440
Name:MUNES, DEBRA KAY (DDS)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:MUNES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:KAY
Other - Last Name:NORTROP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:248 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:OCONTO FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54154
Mailing Address - Country:US
Mailing Address - Phone:920-846-2171
Mailing Address - Fax:
Practice Address - Street 1:248 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:OCONTO FALLS
Practice Address - State:WI
Practice Address - Zip Code:54154
Practice Address - Country:US
Practice Address - Phone:920-846-2171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5028-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist