Healthcare Provider Details

I. General information

NPI: 1215743802
Provider Name (Legal Business Name): TEODOR A MANAOIS DDS, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 OCEAN AVE STE 210
SAN FRANCISCO CA
94132-1646
US

IV. Provider business mailing address

4 BEACHSIDE CT
DALY CITY CA
94015-4710
US

V. Phone/Fax

Practice location:
  • Phone: 415-587-4700
  • Fax:
Mailing address:
  • Phone: 415-518-4823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TEODOR MANAOIS
Title or Position: PRESIDENT
Credential: DDS
Phone: 415-587-4700