Individual
MARCY MUNDAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPA
Contact information
Practice address
1055 E STEWART AVE BLDG 2018, COLORADO SPRINGS, CO 80914-2900
(719) 556-1238
Mailing address
1980 SISKIN LN, COLORADO SPRINGS, CO 80951-4756
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15030223705
TRICARE
—
Enumeration date
10/06/2020
Last updated
10/06/2020
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