Provider Demographics
NPI:1144314113
Name:MANNING, PETER THOMAS (DDS)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:THOMAS
Last Name:MANNING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 MAXEY RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77013
Mailing Address - Country:US
Mailing Address - Phone:713-451-8845
Mailing Address - Fax:
Practice Address - Street 1:503 MAXEY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77013
Practice Address - Country:US
Practice Address - Phone:713-451-8845
Practice Address - Fax:713-451-8937
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12462122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist