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General NPI Number Information
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NPI Number | 1952676652
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Entity Type | Organization
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Legal Business Name | MARGIE L. MANNERING, D.D.S.
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 55 E WASHINGTON ST SUITE 3005
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City | CHICAGO
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State | IL
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Zip | 60602-2103
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Country | US
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Telephone | 312-456-0221
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Fax |
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Provider Business Mailing Address
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Address Line | 55 E WASHINGTON ST SUITE 3005
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City | CHICAGO
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State | IL
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Zip | 60602-2103
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Country | US
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Telephone | 312-456-0221
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MARGIE L MANNERING
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Credential | D.D.S.
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Telephone | 312-456-0221
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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 | 19017234
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License Number State | IL
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