Individual
DR. MACKENSON MONTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2041 GEORGIA AVE NW, WASHINGTON, DC 20060-0002
(516) 754-1168
Mailing address
2041 GEORGIA AVE NW, WASHINGTON, DC 20060-0002
(516) 754-1168
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02801400
NJ
122300000X
Dentist
DN1859008
MA
1223G0001X
General Practice Dentistry
22DI02801400
NJ
1223G0001X
General Practice Dentistry
DN1859008
MA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2020
Last updated
04/19/2023
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