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NPI Code Detail

MEDICARE: DAVINDER S. MANAK DDS. INCORPORATION

MEDICARE: DAVINDER S. MANAK DDS. INCORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry41310CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G92783-01OTHERCADENTICAL PROVIDE

General Provider Information

NPI Number : 1841414067
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVINDER S. MANAK DDS. INCORPORATION
Provider Business Mailing Address
First Line : 1334 S CENTER ST
Second Line :
City : STOCKTON
State : CA
Zip : 95206-1331
Country : US
Telephone Number : 209-460-1223
Fax Number : 209-460-1370
Provider Business Practice Location Address
First Line : 1334 S CENTER ST
Second Line :
City : STOCKTON
State : CA
Zip : 95206-1331
Country : US
Telephone Number : 209-460-1223
Fax Number : 209-460-1370
Authorized Official
Title or Position : OFFICER
Name : DAVINDER SINGH MANAK
Credential : DDS
Telephone Number : 209-460-1223
Provider Enumeration Date : 04/11/2007
Last Update Date : 08/22/2020

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