Provider Demographics
NPI:1306669387
Name:MUNOZ, ALEXANDRA ARRICH (DMD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ARRICH
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 1:1901 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-2470
Mailing Address - Country:US
Mailing Address - Phone:630-554-0040
Mailing Address - Fax:
Practice Address - Street 1:1901 DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IL
Practice Address - Zip Code:60538-2470
Practice Address - Country:US
Practice Address - Phone:630-554-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0353401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice