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General NPI Number Information
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NPI Number | 1043629264
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Entity Type | Organization
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Legal Business Name | MANHATTAN ORAL SURGERY & IMPLANT CENTER
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 08/13/2014
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Provider Practice Location Address
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Address Line | 1133 COLLEGE AVE C200
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City | MANHATTAN
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State | KS
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Zip | 66502-2770
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Country | US
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Telephone | 785-539-7429
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 COLLEGE AVE C200
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City | MANHATTAN
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State | KS
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Zip | 66502-2770
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMAD NOMANI
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Credential | DDS
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Telephone | 785-539-7429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 701
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License Number State | KS
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