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General NPI Number Information
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NPI Number | 1154463743
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Entity Type | Individual
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Provider Name | SERGIO AQUILES MONRAZ D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 173 JOHNSON ST
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City | WINDSOR
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State | CA
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Zip | 95492-7435
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Country | US
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Telephone | 707-838-0444
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Fax | 707-838-4482
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Provider Business Mailing Address
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Address Line | 916 TURNBERRY CT
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City | WINDSOR
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State | CA
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Zip | 95492-7991
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Country | US
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Telephone | 707-838-0444
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Fax | 707-838-4482
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 40683
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License Number State | CA
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