Provider Demographics
NPI:1225358617
Name:KING, MONICA MARIE (DDS)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIE
Last Name:KING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:KING
Other - Last Name:NESBITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2200 E 104TH AVE
Mailing Address - Street 2:#112
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-4404
Mailing Address - Country:US
Mailing Address - Phone:303-452-4142
Mailing Address - Fax:303-254-8360
Practice Address - Street 1:2200 E 104TH AVE
Practice Address - Street 2:#112
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-4404
Practice Address - Country:US
Practice Address - Phone:303-452-4142
Practice Address - Fax:303-254-8360
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO82531223X0400X
TX199551223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics