Provider Demographics
NPI:1417288663
Name:MONICA GARNACHE DMD INC
Entity Type:Organization
Organization Name:MONICA GARNACHE DMD INC
Other - Org Name:NORTH MARIN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARNACHE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:415-479-1273
Mailing Address - Street 1:630 FREITAS PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3106
Mailing Address - Country:US
Mailing Address - Phone:415-479-1273
Mailing Address - Fax:415-479-9840
Practice Address - Street 1:630 FREITAS PKWY
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3106
Practice Address - Country:US
Practice Address - Phone:415-479-1273
Practice Address - Fax:415-479-9840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty