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General NPI Number Information
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NPI Number | 1104030766
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Entity Type | Organization
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Legal Business Name | MANUEL J KANER DDS PC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32300 SCHOOLCRAFT RD
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City | LIVONIA
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State | MI
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Zip | 48150-1866
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Country | US
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Telephone | 734-261-4320
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Fax |
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Provider Business Mailing Address
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Address Line | 32300 SCHOOLCRAFT RD
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City | LIVONIA
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State | MI
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Zip | 48150-1866
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Country | US
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Telephone | 734-261-4320
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANUEL J KANER
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Credential | DDS
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Telephone | 734-261-4320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7866
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License Number State | MI
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