Individual
DR. MONA DERENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
31370 TELEGRAPH RD, BINGHAM FARMS, MI 48025-4356
(805) 630-4541
Mailing address
18 AUTUMN LEAF DR, THOUSAND OAKS, CA 91360-2607
(805) 630-4541
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
100011
CA
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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