Provider Demographics
NPI:1679382642
Name:MONSEF DENTAL CORPORATION
Entity type:Organization
Organization Name:MONSEF DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:
Authorized Official - Last Name:MONSEF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-359-4610
Mailing Address - Street 1:1760 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2226
Mailing Address - Country:US
Mailing Address - Phone:818-359-4610
Mailing Address - Fax:
Practice Address - Street 1:235 S HIGHWAY 101 STE A
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1807
Practice Address - Country:US
Practice Address - Phone:858-321-7668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental