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General NPI Number Information
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NPI Number | 1740949858
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Entity Type | Organization
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Legal Business Name | MONOMOY DENTAL PLLC
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Dates
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Enumeration Date | 12/16/2021
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 527 LONG POND DR
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City | HARWICH
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State | MA
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Zip | 02645-1227
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Country | US
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Telephone | 508-430-0505
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Fax |
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Provider Business Mailing Address
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Address Line | 267 SHEEP POND DR
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City | BREWSTER
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State | MA
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Zip | 02631-2521
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Country | US
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Telephone | 508-728-0581
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. SARAH GIBBONS
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Credential | DMD
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Telephone | 508-720-0581
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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 |
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License Number State |
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