Provider Demographics
NPI:1891229886
Name:MONSEF, EDMUND (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:
Last Name:MONSEF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72650 FRED WARING DR STE 207
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-5009
Mailing Address - Country:US
Mailing Address - Phone:760-340-3341
Mailing Address - Fax:
Practice Address - Street 1:72650 FRED WARING DR STE 207
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-5009
Practice Address - Country:US
Practice Address - Phone:760-340-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1012661223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics