Provider Demographics
NPI:1114019338
Name:KINCADE, MONICA S (DDS)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:S
Last Name:KINCADE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:SMITH
Other - Last Name:KINCADE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:317 DERNIER ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARTINVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70582-3809
Mailing Address - Country:US
Mailing Address - Phone:337-342-2566
Mailing Address - Fax:337-342-2553
Practice Address - Street 1:317 DERNIER ST
Practice Address - Street 2:
Practice Address - City:SAINT MARTINVILLE
Practice Address - State:LA
Practice Address - Zip Code:70582-3809
Practice Address - Country:US
Practice Address - Phone:337-342-2566
Practice Address - Fax:337-342-2553
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA46581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice