Provider Demographics
NPI:1750489753
Name:CLUMSKY, MONTE J (DDS)
Entity Type:Individual
Prefix:DR
First Name:MONTE
Middle Name:J
Last Name:CLUMSKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 IOWA
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046
Mailing Address - Country:US
Mailing Address - Phone:785-832-2828
Mailing Address - Fax:785-832-9898
Practice Address - Street 1:2706 IOWA
Practice Address - Street 2:SUITE A
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046
Practice Address - Country:US
Practice Address - Phone:785-832-2828
Practice Address - Fax:785-832-2828
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4742122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist