Healthcare Provider Details

I. General information

NPI: 1427742568
Provider Name (Legal Business Name): MANAR HANNA GEORGES DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S INDIAN HILL BLVD
CLAREMONT CA
91711-5400
US

IV. Provider business mailing address

1488 SPRINGFIELD WAY
UPLAND CA
91786-7540
US

V. Phone/Fax

Practice location:
  • Phone: 619-920-6628
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number111535
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: