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General NPI Number Information
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NPI Number | 1679938997
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Entity Type | Organization
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Legal Business Name | JOHN E. MONROE DDS PLLC
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Dates
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Enumeration Date | 12/31/2015
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Last Update Date | 12/31/2015
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Provider Practice Location Address
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Address Line | 2417 PACIFIC AVE SE SUITE A
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City | OLYMPIA
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State | WA
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Zip | 98501-2052
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Country | US
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Telephone | 360-878-8002
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Fax |
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Provider Business Mailing Address
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Address Line | 2417 PACIFIC AVE SE SUITE A
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City | OLYMPIA
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State | WA
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Zip | 98501-2052
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Country | US
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Telephone | 360-878-8002
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JOHN E MONROE
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Credential | DDS
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Telephone | 360-878-8002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE00007155
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License Number State | WA
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