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General NPI Number Information
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NPI Number | 1326140823
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Entity Type | Individual
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Provider Name | ROBERT KEITH MANGA DMD
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Gender | Male
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Dates
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Enumeration Date | 09/04/2006
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 316 COUNTY SERVICES PARK
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City | SYLVA
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State | NC
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Zip | 28779
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Country | US
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Telephone | 706-566-2579
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Fax |
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Provider Business Mailing Address
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Address Line | 57 KINROSS LN
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City | WAYNESVILLE
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State | NC
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Zip | 28785-6915
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Country | US
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Telephone | 706-566-2579
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS023825L
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License Number State | PA
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