Provider Demographics
NPI:1588723696
Name:MUNSON AND RUDE PS
Entity type:Organization
Organization Name:MUNSON AND RUDE PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BOYD
Authorized Official - Middle Name:F
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:425-821-7100
Mailing Address - Street 1:11830 NE 128TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7202
Mailing Address - Country:US
Mailing Address - Phone:425-821-7100
Mailing Address - Fax:425-820-8208
Practice Address - Street 1:11830 NE 128TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7202
Practice Address - Country:US
Practice Address - Phone:425-821-7100
Practice Address - Fax:425-820-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA72811223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty