Provider Demographics
NPI:1629244579
Name:ALFONSO MONARRES DDS MS PA
Entity Type:Organization
Organization Name:ALFONSO MONARRES DDS MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONARRES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:210-403-0042
Mailing Address - Street 1:115 N LOOP 1604 E
Mailing Address - Street 2:SUITE 2209
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232
Mailing Address - Country:US
Mailing Address - Phone:210-403-0042
Mailing Address - Fax:210-403-0979
Practice Address - Street 1:115 N LOOP 1604 E
Practice Address - Street 2:SUITE 2209
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232
Practice Address - Country:US
Practice Address - Phone:210-403-0042
Practice Address - Fax:210-403-0979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212201223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty