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NPI Code Detail

MEDICARE: DR. MICHAEL RAY MANSELL DDS

MEDICARE: DR. MICHAEL RAY MANSELL 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
1122300000XDentist26214TX
21223G0001XGeneral Practice Dentistry052050NY
31223G0001XGeneral Practice Dentistry26214TX

General Provider Information

NPI Number : 1932161163
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL RAY MANSELL DDS
Provider Business Mailing Address
First Line : 4431 68TH ST
Second Line :
City : FORT HOOD
State : TX
Zip : 76544-5042
Country : US
Telephone Number : 254-287-5336
Fax Number :
Provider Business Practice Location Address
First Line : 4431 68TH ST
Second Line :
City : FORT HOOD
State : TX
Zip : 76544-5042
Country : US
Telephone Number : 254-287-5336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2006
Last Update Date : 03/31/2023

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Directions to “ DR. MICHAEL RAY MANSELL DDS” Practice Location

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