Provider Demographics
NPI:1700937414
Name:MONOKIAN FAMILY & COSMETIC DENTISTRY LLC
Entity Type:Organization
Organization Name:MONOKIAN FAMILY & COSMETIC DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:R
Authorized Official - Last Name:GIRGENTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-983-9620
Mailing Address - Street 1:151 W GREENTREE RD STE A
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-9416
Mailing Address - Country:US
Mailing Address - Phone:856-983-9620
Mailing Address - Fax:856-983-7714
Practice Address - Street 1:151 W GREENTREE RD STE A
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9416
Practice Address - Country:US
Practice Address - Phone:856-983-9620
Practice Address - Fax:856-983-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ107051223G0001X
NJ10229271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty