Provider Demographics
NPI:1700121449
Name:JOANNE MANY,DMD PC
Entity type:Organization
Organization Name:JOANNE MANY,DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-520-9225
Mailing Address - Street 1:124 BOARDMAN ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1051
Mailing Address - Country:US
Mailing Address - Phone:508-520-9225
Mailing Address - Fax:508-520-9863
Practice Address - Street 1:124 BOARDMAN ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:MA
Practice Address - Zip Code:02056-1051
Practice Address - Country:US
Practice Address - Phone:508-520-9225
Practice Address - Fax:508-520-9863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty