Smith, Monique Dase

Smith, Monique Dase is an individual health care provider with primary practice located at 1717 W Cowles St , Fairbanks AK 99701-5926. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Smith, Monique Dase can be contacted via phone (907) 459-3800.

Contact Information

Primary practice address
1717 W Cowles St Fairbanks AK 99701-5926
Phone: (907) 459-3800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD0000048750 Tennessee
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 7667 Alaska

Profile Details

NPI number 1174796247
LBN Legal business name Smith, Monique Dase
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2008
Last updated May 18th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174796247 NPPES
Alaska MEDICAID 1600801

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