MEDICARE: KAREN ANN MONROY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901018848	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	88170MI	OTHER	OUTER DRIVE
3	381908328020	OTHER	DENTAL BLUE
4	88171MI	OTHER	COMMERCE
5	D801095	OTHER	BLUE CROSS
6	O1618779	OTHER	UNITED CONCORDIA
7	374041755000	OTHER	SERVICING PROVIDER NUMBER
8	88123MI	OTHER	BAYSIDE
9	88096MI	OTHER	WADSWORTH

General Provider Information

NPI Number	:	1134117443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ANN MONROY D.D.S.

Provider Business Mailing Address
First Line	:	104 W COLBY ST
Second Line	:
City	:	WHITEHALL
State	:	MI
Zip	:	49461-2005
Country	:	US
Telephone Number	:	231-893-6075
Fax Number	:	231-893-1144

Provider Business Practice Location Address
First Line	:	104 W COLBY ST
Second Line	:
City	:	WHITEHALL
State	:	MI
Zip	:	49461-2005
Country	:	US
Telephone Number	:	231-893-6075
Fax Number	:	231-893-1144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	09/25/2007

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Directions to “ KAREN ANN MONROY D.D.S.” Practice Location

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