MEDICARE: JAMES E. MANNING JR., D. D. S., LLC

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	1223G0001X	General Practice Dentistry	4683T	NV

General Provider Information

NPI Number	:	1780852681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES E. MANNING JR., D. D. S., LLC

Provider Business Mailing Address
First Line	:	3595 US HIGHWAY 50 WEST
Second Line	:	#4
City	:	SILVER SPRINGS
State	:	NV
Zip	:	89429
Country	:	US
Telephone Number	:	775-577-9999
Fax Number	:	775-577-9555

Provider Business Practice Location Address
First Line	:	3595 US HIGHWAY 50 WEST
Second Line	:	#4
City	:	SILVER SPRINGS
State	:	NV
Zip	:	89429
Country	:	US
Telephone Number	:	775-577-9999
Fax Number	:	775-577-9555

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES E MANNING JR.
Credential	:	D. D. S.
Telephone Number	:	775-577-9999

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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