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General NPI Number Information
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NPI Number | 1760445217
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Entity Type | Organization
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Legal Business Name | DENTAL ASSOCIATES OF MANHATTAN
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1133 COLLEGE AVE BUILDING D, SUITE 202
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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 | 785-539-7401
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 COLLEGE AVE BUILDING D, SUITE 202
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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 | 785-539-7401
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | RICK A FULTON
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Credential | D.D.S.
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Telephone | 785-539-7401
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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 | 5871
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License Number State | KS
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