Provider Demographics
NPI:1760543573
Name:RAO, MONICA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:RAO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:DCHAR
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:2 JANE STREET
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545
Mailing Address - Country:US
Mailing Address - Phone:508-754-6767
Mailing Address - Fax:
Practice Address - Street 1:5 ENGLEWOOD ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-2048
Practice Address - Country:US
Practice Address - Phone:508-943-6908
Practice Address - Fax:508-949-0938
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA19868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist