Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 27906 | CA |
NPI | 1033358569 |
---|---|
Provider Name | Dr. Clifford John Munce |
First Address | Santa Barbara, CA 93101-2500 |
Second Address | Santa Barbara, CA 93101-2500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2009 |
Last Update Date | 05/02/2009 |