Provider Demographics
NPI:1063661304
Name:MANNING, DAWN ELISHA (DENTAL HYGINIEST)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:ELISHA
Last Name:MANNING
Suffix:
Gender:F
Credentials:DENTAL HYGINIEST
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:ELISHA
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:129 NOTTINGHAM BLVD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-9137
Mailing Address - Country:US
Mailing Address - Phone:757-331-6313
Mailing Address - Fax:
Practice Address - Street 1:USS IWO JIMA LHD7
Practice Address - Street 2:ATTN MEDICAL DEPARTMENT HM1 (SW/AW) MANNING
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09574-4664
Practice Address - Country:US
Practice Address - Phone:757-449-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist