# RONALD JAY MUNDEN, D.D.S.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Munden Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184006959
- **Authorized official:** DR. RONALD JAY MUNDEN D.D.S (DENTIST/OWNER)
- **Authorized official phone:** (812) 384-4191

## Contact information

- **Practice address:** 124 E INDIANA AVE, BLOOMFIELD, IN 47424-1045
- **Practice address phone:** (812) 384-4191
- **Practice address fax:** (812) 384-4191
- **Mailing address:** 124 E INDIANA AVE, BLOOMFIELD, IN 47424-1045
- **Mailing address phone:** (812) 384-4191
- **Mailing address fax:** (812) 384-4191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12008928A | IN | Yes |

## Other

- **Enumeration date:** 06/29/2015
- **Last updated:** 07/01/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100124920 | — | IN |