Basic Information
| Provider Information | |||||||||
| NPI: | 1649646258 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MONSON | ||||||||
| FirstName: | SETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2905 CARPENTER RD SE | ||||||||
| Address2: | |||||||||
| City: | LACEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985033956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604805242 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2103 NORTH DIVISION ST | ||||||||
| Address2: | |||||||||
| City: | APO | ||||||||
| State: | AA | ||||||||
| PostalCode: | 98433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539673416 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2015 | ||||||||
| LastUpdateDate: | 08/18/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DE60572166 | WA | Y | Dental Providers | Dentist |
No ID Information.