Provider Demographics
NPI:1326220385
Name:JOHN F MONACELL DDS PC
Entity Type:Organization
Organization Name:JOHN F MONACELL DDS PC
Other - Org Name:MONACELL ORTHODONTICS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MONACELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-737-6757
Mailing Address - Street 1:1343 E WILLIAMSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SANDSTON
Mailing Address - State:VA
Mailing Address - Zip Code:23150-1723
Mailing Address - Country:US
Mailing Address - Phone:804-737-6757
Mailing Address - Fax:804-737-1745
Practice Address - Street 1:1343 E WILLIAMSBURG RD
Practice Address - Street 2:
Practice Address - City:SANDSTON
Practice Address - State:VA
Practice Address - Zip Code:23150-1723
Practice Address - Country:US
Practice Address - Phone:804-737-6757
Practice Address - Fax:804-737-1745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010044641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty