Provider Demographics
NPI:1942435169
Name:QUENTIN E. MONROE DENTAL SERVICES,PC
Entity type:Organization
Organization Name:QUENTIN E. MONROE DENTAL SERVICES,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:QUENTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-505-6055
Mailing Address - Street 1:5448 SAINT BARNABAS RD
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3622
Mailing Address - Country:US
Mailing Address - Phone:301-505-6055
Mailing Address - Fax:301-505-4820
Practice Address - Street 1:5448 SAINT BARNABAS RD
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3622
Practice Address - Country:US
Practice Address - Phone:301-505-6055
Practice Address - Fax:301-505-4820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD191840Medicaid