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Individual
DR. LYLE KRIS MUNK
Active
Individual
DR. LYLE KRIS MUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D204105
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002667500
—
ID
01
—
41383
BLUE SHIELD
ID
01
—
60194
BLUE CROSS
ID
Enumeration date
11/01/2006
Last updated
07/08/2007
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