MEDICARE: DR. RICHARD K. MANN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6372	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447230966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD K. MANN DDS

Provider Business Mailing Address
First Line	:	7100 BROADWAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-2917
Country	:	US
Telephone Number	:	303-650-5800
Fax Number	:	303-650-5800

Provider Business Practice Location Address
First Line	:	7100 BROADWAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-2917
Country	:	US
Telephone Number	:	303-650-5800
Fax Number	:	303-650-5800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	07/09/2007

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