Provider Demographics
NPI:1346903465
Name:SEAN MONAGHAN DMD PLLC
Entity Type:Organization
Organization Name:SEAN MONAGHAN DMD PLLC
Other - Org Name:COLE STREET DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-825-5527
Mailing Address - Street 1:1233 COLE ST
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-2602
Mailing Address - Country:US
Mailing Address - Phone:360-825-5527
Mailing Address - Fax:
Practice Address - Street 1:1233 COLE ST
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2602
Practice Address - Country:US
Practice Address - Phone:360-825-5527
Practice Address - Fax:360-802-2563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental