Provider Demographics
NPI:1164487815
Name:SWITZER, MONICA D (DMD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:D
Last Name:SWITZER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W 8TH ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3038
Mailing Address - Country:US
Mailing Address - Phone:719-562-4447
Mailing Address - Fax:
Practice Address - Street 1:3362 S MCCARRAN BLVD
Practice Address - Street 2:UNIT 3362
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6442
Practice Address - Country:US
Practice Address - Phone:775-329-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK45180122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100114430AMedicaid