Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DS039904 | PA |
NPI | 1003290347 |
---|---|
Provider Name | Dr. Alexandra Hillyard Monroe |
First Address | Media, PA 19063-1544 |
Second Address | Media, PA 19063-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2015 |
Last Update Date | 16/07/2015 |