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General NPI Number Information
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NPI Number | 1629075510
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Entity Type | Individual
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Provider Name | MICHAEL S. MONTO DMD, MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 576 N MAIN ST
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City | SPRINGBORO
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State | OH
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Zip | 45066-9552
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Country | US
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Telephone | 937-748-8814
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Fax | 937-748-8817
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Provider Business Mailing Address
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Address Line | 576 N MAIN ST
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City | SPRINGBORO
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State | OH
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Zip | 45066-9552
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Country | US
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Telephone | 937-748-8814
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Fax | 937-748-8817
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 045048
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS035287
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 30.023127
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License Number State | OH
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