Organization
MONESMITH & WOOD ORAL AND MAXILLOFACIAL SURGERY PC
Active
Other names
Matthew B Monesmith DDS PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW BRIAN MONESMITH DDS (PRESIDENT ORAL SURGEON)
(812) 482-2280
Entity
Organization
Contact information
Practice address
2005 ST CHARLES STREET, SUITE 2, JASPER, IN 47546-9146
(812) 482-2280
(812) 482-4218
Mailing address
2005 ST CHARLES STREET, SUITE 2, JASPER, IN 47546-9146
(812) 482-2280
(812) 482-4218
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12009137
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12009891A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093454
ANTHEM
IN
01
—
000000351646
ANTHEM
IN
Enumeration date
07/17/2006
Last updated
08/22/2020
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