Munk, Lyle Kris
Munk, Lyle Kris is an individual health care provider with primary practice located at 2588 Channing Way , Idaho Falls ID 83404. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Munk, Lyle Kris can be contacted via phone (208) 524-3200.Contact Information
Primary practice address
2588 Channing Way
Idaho Falls ID 83404
Phone: (208) 524-3200
Fax: (208) 524-3531
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | D204105 | Idaho |
Profile Details
| NPI number | 1417034190 |
|---|---|
| LBN Legal business name | Munk, Lyle Kris |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417034190 | NPPES |
| Idaho | MEDICAID | 002667500 | |
| Idaho | Other | 41383 | |
| Idaho | Other | 60194 |
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