Individual
JOSEPH ROBERT MUCKENTHALER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1647 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 23511
(757) 953-8547
Mailing address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 546-7139
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2901020028
MI
1223P0700X
Prosthodontics
Primary
2901020028
MI
Other
Enumeration date
07/10/2009
Last updated
09/19/2023
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