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General NPI Number Information
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NPI Number | 1154497535
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Entity Type | Organization
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Legal Business Name | DANIEL B MANLEY DMD PSC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 1107 C INDIAN MOUND DRIVE SUITE C
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City | MT STERLING
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State | KY
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Zip | 40353
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Country | US
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Telephone | 859-498-2356
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Fax | 859-498-2413
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Provider Business Mailing Address
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Address Line | 1107 C INDIAN MOUND DRIVE SUITE C
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City | MT STERLING
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State | KY
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Zip | 40353
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Country | US
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Telephone | 859-498-2356
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Fax | 859-498-2413
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Authorized Official
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Title or Position | DMD PSC
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Name | DR. DANIEL BRUCE MANLEY
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Credential | DMD
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Telephone | 859-498-2356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5357
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License Number State | KY
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