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General NPI Number Information
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NPI Number | 1871664805
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Entity Type | Individual
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Provider Name | MONICA JOHNSON CAYOUETTE DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 173 ASHLEY AVE # 546
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City | CHARLESTON
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State | SC
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Zip | 29425-0001
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Country | US
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Telephone | 843-792-6451
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Fax | 843-792-1593
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Provider Business Mailing Address
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Address Line | 173 ASHLEY AVE # 546
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City | CHARLESTON
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State | SC
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Zip | 29425-0001
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Country | US
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Telephone | 843-556-3162
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | SC 3399
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | PROS 0532
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License Number State | SC
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