Provider Demographics
NPI:1639345473
Name:MONTE J. CAREL D.D.S.
Entity Type:Organization
Organization Name:MONTE J. CAREL D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CAREL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-256-6262
Mailing Address - Street 1:PO BOX 1318
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-8318
Mailing Address - Country:US
Mailing Address - Phone:405-256-6262
Mailing Address - Fax:405-256-6675
Practice Address - Street 1:317 S SARA RD
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-4311
Practice Address - Country:US
Practice Address - Phone:405-256-6262
Practice Address - Fax:405-256-6675
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
OK5598122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200020010BMedicaid
1467539049OtherNPI TYPE I