Provider Demographics
NPI:1619197738
Name:MONKMAN, ANDREA BETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:BETH
Last Name:MONKMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:BETH
Other - Last Name:JANOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:30233 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-2283
Mailing Address - Country:US
Mailing Address - Phone:248-588-2930
Mailing Address - Fax:248-588-2934
Practice Address - Street 1:30233 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2283
Practice Address - Country:US
Practice Address - Phone:248-588-2930
Practice Address - Fax:248-588-2934
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010193541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice