Provider Demographics
NPI:1205973393
Name:GARNACHE, MONICA ARABELLE (DMD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:ARABELLE
Last Name:GARNACHE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 E 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169-3415
Mailing Address - Country:US
Mailing Address - Phone:415-328-6966
Mailing Address - Fax:
Practice Address - Street 1:1298 W GRANADA BLVD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5901
Practice Address - Country:US
Practice Address - Phone:386-682-3950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554321223G0001X
FL27179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice