# MAX MONCAYO DDS DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Palisades Surgical Arts
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053845172
- **Authorized official:** DR. MAX PAUL MONCAYO DDS (PRESIDENT)
- **Authorized official phone:** (310) 459-0014

## Contact information

- **Practice address:** 881 ALMA REAL DR, SUITE T4, PACIFIC PALISADES, CA 90272-3731
- **Practice address phone:** (310) 459-0014
- **Mailing address:** 881 ALMA REAL DR, SUITE T4, PACIFIC PALISADES, CA 90272-3731
- **Mailing address phone:** (310) 459-0014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 53926 | CA | Yes |

## Other

- **Enumeration date:** 04/14/2017
- **Last updated:** 04/14/2017