Provider Demographics
NPI:1598727125
Name:MONTI, RICHARD (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:MONTI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7031 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:PRESTO
Mailing Address - State:PA
Mailing Address - Zip Code:15142-1062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 N GREENGATE RD STE 310
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7460
Practice Address - Country:US
Practice Address - Phone:724-853-2355
Practice Address - Fax:724-853-0935
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0217431223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA091528OtherHIGHMARK BCBS #
PA0009928160023Medicaid