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General NPI Number Information
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NPI Number | 1801777404
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Entity Type | Organization
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Legal Business Name | GURSIMRAN MANAISE, PLLC
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 386 N YORK ST STE 203
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City | ELMHURST
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State | IL
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Zip | 60126-2367
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Country | US
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Telephone | 630-530-0770
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Fax |
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Provider Business Mailing Address
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Address Line | 386 N YORK ST STE 203
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City | ELMHURST
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State | IL
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Zip | 60126-2367
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Country | US
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Telephone | 630-530-0770
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GURSIMRAN REEN MANAISE
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Credential | DMD, MPH
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Telephone | 330-423-3528
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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 |
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License Number State |
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