Individual
DR. LYLE KRIS MUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2588 CHANNING WAY, IDAHO FALLS, ID 83404
(208) 524-3200
(208) 524-3531
Mailing address
2588 CHANNING WAY, IDAHO FALLS, ID 83404
(208) 524-3200
(208) 524-3531
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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